Low molecular weight heparin: Difference between revisions
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imported>Robert Badgett (New page: In hematology, '''low molecular weight heparin''' is an anticoagulant that consists of "heparin fractions with a molecular weight usually between 4000 and 6000 kD. These low-molecu...) |
imported>Howard C. Berkowitz No edit summary |
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In [[hematology]], '''low molecular weight heparin''' is an [[anticoagulant]] that consists of "heparin fractions with a molecular weight usually between 4000 and 6000 kD. These low-molecular-weight fractions are effective [[antithrombotic agent]]s. Their administration reduces the risk of [[hemorrhage]], they have a longer half-life, and their platelet interactions are reduced in comparison to unfractionated heparin. They also provide an effective prophylaxis against postoperative major [[pulmonary embolism]]."<ref>{{MeSH}}</ref> | {{subpages}} | ||
{{TOC|right}} | |||
In [[hematology]], '''low molecular weight heparin (LMWH)''' is an [[anticoagulant]] that consists of "heparin fractions with a molecular weight usually between 4000 and 6000 kD. These low-molecular-weight fractions are effective [[antithrombotic agent]]s. Their administration reduces the risk of [[hemorrhage]], they have a longer half-life, and their platelet interactions are reduced in comparison to unfractionated heparin. They also provide an effective prophylaxis against postoperative major [[pulmonary embolism]]."<ref>{{MeSH}}</ref> | |||
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| Dalteparin<br/>(Framin)|| After loading, 2500 to 5000 int. units daily|| 150 int. units/kg up to 18,000 int. units) once daily<br/>dosing is complicated and more information is at [http://dailymed.nlm.nih.gov/dailymed/search.cfm?startswith=Dalteparin DailyMed]|| If [[creatinine clearance]] is less then 30 mL/minute, monitor anti-Xa levels | | Dalteparin<br/>(Framin)|| After loading, 2500 to 5000 int. units daily|| 150 int. units/kg up to 18,000 int. units) once daily<br/>dosing is complicated and more information is at [http://dailymed.nlm.nih.gov/dailymed/search.cfm?startswith=Dalteparin DailyMed]|| If [[creatinine clearance]] is less then 30 mL/minute, monitor anti-Xa levels | ||
|} | |} | ||
==Oncology== | |||
Venous thromboembolism (VTE), usually as [[pulmonary embolism]] (PE) or [[deep vein thrombosis]], is the second leading cause of death in patients with cancer. While less than 5% of cancer patients routinely receive VTE prophylaxis, for which LMWH is preferred,<ref>{{citation | |||
| journal = Annals of Oncology | |||
| year = 2009 | |||
| volume = 20 | |||
| issue = 10 | pages = 1619-1630 | |||
| title = Cancer and Thrombosis: Implications of Published Guidelines for Clinical Practice | |||
| author = Khorana AA | |||
| url = http://www.medscape.com/viewarticle/709899 | |||
}}</ref> the American Society of Clinical Oncology (ASCO),<ref>Lyman GH, Khorana AA, Falanga A, et al. American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol 2007; 25: 5490-5505.</ref> the American College of Chest Physicians (ACCP),<ref>Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. (8th edition). Chest 2008; 133: (6 Suppl): 381S-453S.</ref> and the National Comprehensive Cancer Network (NCCN)<ref>NCCN Clinical Practice Guidelines in Oncology. Venous Thromboembolic Disease. http://www.nccn.org/professionals/physician_gls/PDF/vte.pdf. (1 November 2008, date last accessed)</ref> have all recently issued clinical practice guidelines for the prevention and treatment of cancer-associated thrombosis. , | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 12:42, 1 November 2009
In hematology, low molecular weight heparin (LMWH) is an anticoagulant that consists of "heparin fractions with a molecular weight usually between 4000 and 6000 kD. These low-molecular-weight fractions are effective antithrombotic agents. Their administration reduces the risk of hemorrhage, they have a longer half-life, and their platelet interactions are reduced in comparison to unfractionated heparin. They also provide an effective prophylaxis against postoperative major pulmonary embolism."[1]
| Prophylaxis dose | Full dose | Comments | |
|---|---|---|---|
| Enoxiparin (Lovenox) |
Either: 30 mg twice daily 40 mg once daily |
Either: 1 mg/kg/dose every 12 hours 1.5 mg/kg once daily more information is at Enoxaparin |
|
| Dalteparin (Framin) |
After loading, 2500 to 5000 int. units daily | 150 int. units/kg up to 18,000 int. units) once daily dosing is complicated and more information is at DailyMed |
If creatinine clearance is less then 30 mL/minute, monitor anti-Xa levels |
Oncology
Venous thromboembolism (VTE), usually as pulmonary embolism (PE) or deep vein thrombosis, is the second leading cause of death in patients with cancer. While less than 5% of cancer patients routinely receive VTE prophylaxis, for which LMWH is preferred,[2] the American Society of Clinical Oncology (ASCO),[3] the American College of Chest Physicians (ACCP),[4] and the National Comprehensive Cancer Network (NCCN)[5] have all recently issued clinical practice guidelines for the prevention and treatment of cancer-associated thrombosis. ,
References
- ↑ Anonymous (2024), Low molecular weight heparin (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Khorana AA (2009), "Cancer and Thrombosis: Implications of Published Guidelines for Clinical Practice", Annals of Oncology 20 (10): 1619-1630
- ↑ Lyman GH, Khorana AA, Falanga A, et al. American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol 2007; 25: 5490-5505.
- ↑ Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. (8th edition). Chest 2008; 133: (6 Suppl): 381S-453S.
- ↑ NCCN Clinical Practice Guidelines in Oncology. Venous Thromboembolic Disease. http://www.nccn.org/professionals/physician_gls/PDF/vte.pdf. (1 November 2008, date last accessed)