Trade name: Clexane
Pharmacology
Pharmacodynamics:
Mechanism of action
Facilitates antithrombin binding to prothrombin but not thrombin
Pharmacokinetics:
Administration: subcutaneously so patients can even do it themselves. Always adjusted to body weight. do not give iv or im
Distribution: increased bioavailability when compared with UF heparin
Metabolism:
Excretion: Half life is 4-6 hours (longer than heparin) and is eliminated in urine (so you need a patient with good renal function)
Indications:
Its really fast so used to
- prevent DVT (prophylaxis) post op immobile patients etc
- treat DVT - bridging therapy with warfarin
- coronary syndromes (sometimes)
Contraindications:
Risks and ADRS:
if overcooked
haemorrhage
bruising
elevated AST ALT and hyperkalaemia
thrombocytopenia not generally considered major
Interactions:
Other notes
not as reversible with protamine sulphate as with UF hepatin
action is assessed using antifactor Xa activity