PMID- 22315264
OWN - NLM
STAT- MEDLINE
DCOM- 20120413
LR  - 20240404
IS  - 1931-3543 (Electronic)
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 141
IP  - 2 Suppl
DP  - 2012 Feb
TI  - Parenteral anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 
      9th ed: American College of Chest Physicians Evidence-Based Clinical Practice 
      Guidelines.
PG  - e24S-e43S
LID - S0012-3692(12)60118-4 [pii]
LID - 10.1378/chest.11-2291 [doi]
AB  - This article describes the pharmacology of approved parenteral anticoagulants. 
      These include the indirect anticoagulants, unfractionated heparin (UFH), 
      low-molecular-weight heparins (LMWHs), fondaparinux, and danaparoid, as well as 
      the direct thrombin inhibitors hirudin, bivalirudin, and argatroban. UFH is a 
      heterogeneous mixture of glycosaminoglycans that bind to antithrombin via a 
      unique pentasaccharide sequence and catalyze the inactivation of thrombin, factor 
      Xa, and other clotting enzymes. Heparin also binds to cells and plasma proteins 
      other than antithrombin causing unpredictable pharmacokinetic and pharmacodynamic 
      properties and triggering nonhemorrhagic side effects, such as heparin-induced 
      thrombocytopenia (HIT) and osteoporosis. LMWHs have greater inhibitory activity 
      against factor Xa than thrombin and exhibit less binding to cells and plasma 
      proteins than heparin. Consequently, LMWH preparations have more predictable 
      pharmacokinetic and pharmacodynamic properties, have a longer half-life than 
      heparin, and are associated with a lower risk of nonhemorrhagic side effects. 
      LMWHs can be administered once daily or bid by subcutaneous injection, without 
      coagulation monitoring. Based on their greater convenience, LMWHs have replaced 
      UFH for many clinical indications. Fondaparinux, a synthetic pentasaccharide, 
      catalyzes the inhibition of factor Xa, but not thrombin, in an 
      antithrombin-dependent fashion. Fondaparinux binds only to antithrombin. 
      Therefore, fondaparinux-associated HIT or osteoporosis is unlikely to occur. 
      Fondaparinux exhibits complete bioavailability when administered subcutaneously, 
      has a longer half-life than LMWHs, and is given once daily by subcutaneous 
      injection in fixed doses, without coagulation monitoring. Three additional 
      parenteral direct thrombin inhibitors and danaparoid are approved as alternatives 
      to heparin in patients with HIT.
FAU - Garcia, David A
AU  - Garcia DA
AD  - University of New Mexico, Albuquerque, NM. Electronic address: 
      davgarcia@salud.unm.edu.
FAU - Baglin, Trevor P
AU  - Baglin TP
AD  - Cambridge University Hospitals NHS Trust, Addenbrooke's Hospital, Cambridge, 
      England.
FAU - Weitz, Jeffrey I
AU  - Weitz JI
AD  - Thrombosis and Atherosclerosis Research Institute and McMaster University, 
      Hamilton, ON, Canada.
FAU - Samama, Meyer Michel
AU  - Samama MM
AD  - Hotel Dieu University Hospital, Place du Parvis Notre Dame, Paris, France.
LA  - eng
GR  - R13 HL104758/HL/NHLBI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Practice Guideline
PT  - Review
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
RN  - 0 (Antithrombins)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Pipecolic Acids)
RN  - 0 (Polysaccharides)
RN  - 0 (Recombinant Proteins)
RN  - 0 (Sulfonamides)
RN  - 24967-94-0 (Dermatan Sulfate)
RN  - 9005-49-6 (Heparin)
RN  - 9007-28-7 (Chondroitin Sulfates)
RN  - 9050-30-0 (Heparitin Sulfate)
RN  - 94ZLA3W45F (Arginine)
RN  - BI6GY4U9CW (danaparoid)
RN  - EC 3.4.21.5 (Thrombin)
RN  - IY90U61Z3S (argatroban)
RN  - J177FOW5JL (Fondaparinux)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
EIN - Chest. 2012 May;141(5):1369. Dosage error in article text
EIN - Chest. 2013 Aug;144(2):721. Dosage error in article text
CIN - Chest. 2013 Jun;143(6):1840-1. PMID: 23732612
MH  - Antithrombins/agonists
MH  - Arginine/analogs & derivatives
MH  - Chondroitin Sulfates/administration & dosage/adverse effects
MH  - Dermatan Sulfate/administration & dosage/adverse effects
MH  - Dose-Response Relationship, Drug
MH  - *Evidence-Based Medicine
MH  - Fibrinolytic Agents/*administration & dosage
MH  - Fondaparinux
MH  - Heparin/administration & dosage/adverse effects
MH  - Heparin, Low-Molecular-Weight/administration & dosage/adverse effects
MH  - Heparitin Sulfate/administration & dosage/adverse effects
MH  - Hirudins/administration & dosage/adverse effects
MH  - Humans
MH  - Infusions, Intravenous
MH  - Peptide Fragments/administration & dosage/adverse effects
MH  - Pipecolic Acids/administration & dosage/adverse effects
MH  - Polysaccharides/administration & dosage/adverse effects
MH  - *Practice Guidelines as Topic
MH  - Recombinant Proteins/administration & dosage/adverse effects
MH  - *Societies, Medical
MH  - Sulfonamides
MH  - Thrombin/antagonists & inhibitors
MH  - Thrombosis/blood/*drug therapy/*prevention & control
MH  - United States
PMC - PMC3278070
EDAT- 2012/02/15 06:00
MHDA- 2012/04/14 06:00
PMCR- 2013/02/01
CRDT- 2012/02/09 06:00
PHST- 2012/02/09 06:00 [entrez]
PHST- 2012/02/15 06:00 [pubmed]
PHST- 2012/04/14 06:00 [medline]
PHST- 2013/02/01 00:00 [pmc-release]
AID - S0012-3692(12)60118-4 [pii]
AID - 112291 [pii]
AID - 10.1378/chest.11-2291 [doi]
PST - ppublish
SO  - Chest. 2012 Feb;141(2 Suppl):e24S-e43S. doi: 10.1378/chest.11-2291.