Heparin, Fondaparinux, and Novel Oral Anticoagulants ...
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Heparin, Fondaparinux, and Novel Oral Anticoagulants - Pathophysiology


Anticoagulation with parenteral (intravenous or subcutaneous) and oral anticoagulants is the mainstay of VTE therapy. Typically, one of the parenteral agents (e.g. heparin, LMWH, or fondaparinux) or a new oral anticoagulant (e.g. rivaroxaban) is started first. The patient may be transitioned to a traditional oral anticoagulant (e.g. warfarin) for chronic anticoagulation.

 - Unfractionated heparin (UFH): Inhibits the function of thrombin as well as Xa by inducing conformational changes in antithrombin, allowing it to bind the enzymes better.
 - Low molecular weight heparin (LMWH): Functions similar to UFH, but due to the smaller average heparin chain length, accelerates the bridging of AT with Xa only, and not thrombin.
 - Fondaparinux: A pentasaccharide sequence that directly binds to AT (at an allosteric site) and induces a conformational change allowing it to bind and inhibit factor Xa only. 
 - Rivaroxaban: A new oral anticoagulant that inhibits factor Xa by binding to its active site.


#Pharmacology #Pathophysiology #Heparins #LMWH #UFH #DOAC #Dabigatran #Apixaban #Rivaroxaban #Fondaparinux #NOAC #Mechanism
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief πŸ‡΅πŸ‡­ πŸ‡ΊπŸ‡Έ - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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