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The use of LMWH has allowed once-daily dosing, thus not requiring a continuous infusion of the drug. If long-term anticoagulation is required, heparin is often used only to commence anticoagulation therapy until an oral anticoagulant e.g. warfarin takes effect. The American College of Chest Physicians publishes clinical guidelines on heparin ...
With the growing number of patients taking oral anticoagulation therapy, studies into reversal agents are gaining increasing interest due to major bleeding events and the need for urgent anticoagulant reversal therapy. [112] Reversal agents for warfarin are more widely studied, and established guidelines for reversal exist due to a longer ...
Low-molecular-weight heparin (LMWH) is a class of anticoagulant medications. [1] They are used in the prevention of blood clots and, in the treatment of venous thromboembolism ( deep vein thrombosis and pulmonary embolism ), and the treatment of myocardial infarction .
An antithrombotic agent is a drug that reduces the formation of blood clots (). [1] [2] Antithrombotics can be used therapeutically for prevention (primary prevention, secondary prevention) or treatment of a dangerous blood clot (acute thrombus).
It is administered intravenously (into a vein) or subcutaneously (below the skin). Heparin can exert an immediate anti-clotting effect which is useful for the treatment of acute symptoms. [36] Besides, heparin therapy is indicated for anticoagulation during pregnancy as it does not cross the placenta and is not associated with fetal malformations.
The European Society of Cardiology (ESC), [25] and National Institute for Health and Care Excellence (NICE) [27] guidelines recommend that if the patient has a CHA 2 DS 2-VASc score of 2 and above, oral anticoagulation therapy (OAC) with a vitamin K antagonist (VKA, e.g. warfarin with target INR of 2-3) or one of the direct oral anticoagulant ...
Patients undergoing PCI also need an anticoagulant to prevent catheter thrombosis. Options include unfractionated heparin, enoxaparin (a low molecular weight heparin), fondaparinux (a pentasaccharide antagonist of factor Xa) and bivalirudin (a direct thrombin inhibitor); all the above agents are given parenterally (subcutaneously or intravenously).
However, people with homozygous factor V Leiden, and people with heterozygous factor V Leiden who have an additional thrombophilic condition (e.g., antithrombin deficiency, protein C deficiency, or protein S deficiency), should be considered for lifelong oral anticoagulation therapy. [17]