Why is fondaparinux used in ACS?
Fondaparinux provides a prophylactic level of anticoagulation and thus this will also act as a thromboprophylactic agent in these patients. As Fondaparinux at this dose provides a prophylactic level of anticoagulation it is not suitable for indications where a therapeutic level of anticoagulation is required eg.
What is the mechanism of action of fondaparinux?
The mechanism of action of fondaparinux is as a Factor Xa Inhibitor.
Why is fondaparinux used in Nstemi?
In routine clinical care of patients with NSTEMI, fondaparinux compared with LMWH was associated with lower odds of major bleeding events and death both in-hospital and up to 180 days.
Do you give fondaparinux in STEMI?
In the setting of STEMI, fondaparinux is recommended over no anticoagulation, in patients not undergoing reperfusion, in case of thrombolytic therapy, but not in case of primary angioplasty (Figure 1).
Why is fondaparinux used instead of enoxaparin?
Fondaparinux is an alternative to enoxaparin because it preserves short-term efficacy but substantially reduces bleeding. This effect translates into lower long-term rates of death, myocardial infarction, and stroke.
How is fondaparinux different from heparin?
Thins the blood and treats blood clots. Arixtra (fondaparinux) is effective at treating clots, but it can increase your risk of bleeding. Prevents blood clots.
Why is Fondaparinux used instead of enoxaparin?
When do you give Fondaparinux?
The recommended dose of fondaparinux is 2.5 mg once daily administered post-operatively by subcutaneous injection. The initial dose should be given 6 hours following surgical closure provided that haemostasis has been established.
How long is Fondaparinux given in Nstemi?
All patients received standard medical treatment for UA/NSTEMI, with 34% of patients undergoing PCI and 9% undergoing CABG. The mean treatment duration was 5.5 days in the fondaparinux group and 5.2 days in the enoxaparin group.
What is the difference between enoxaparin and fondaparinux?
Fondaparinux is a factor Xa inhibitor and does not inhibit thrombin (IIa) . Enoxaparin on the other hand, binds to antithrombin to form a complex molecule that can irreversibly inactivate clotting factor Xa and it has less activity against thrombin . This is how these two anticoagulants work.
Why is fondaparinux in HIT?
Perspective: For patients with HIT, it is critical to initiate nonheparin anticoagulation in order to prevent both thrombotic and bleeding complications. Use of fondaparinux, a selective factor Xa inhibitor, is common for treatment of HIT, albeit without Food and Drug Administration approval.
Is there an antidote for fondaparinux?
Contrary to UFH or LMWHs, fondaparinux is not neutralized by protamine sulfate, and no antidote is available to counteract bleeding disorders associated with overdosing.
What is the antidote for fondaparinux?
There is no specific antidote for fondaparinux: it is not neutralised by protamine sulphate. Fondaparinux shows no cross-reactivity with antibodies associated with heparin-induced thrombocytopenia.
When do you give fondaparinux?
When should fondaparinux be used?
For prevention of deep vein thrombosis following hip fracture surgery, or hip or knee replacement surgery: Adults—2.5 milligrams (mg) injected under the skin once a day for 5 to 9 days. The first dose is given 6 to 8 hours after surgery. Children—Use and dose must be determined by your doctor.
Why does fondaparinux not cause HIT?
Fondaparinux does not cause HIT because it does not bind to PF4. In contrast to LMWH, there is no cross-reactivity of fondaparinux with HIT antibodies. Consequently, fondaparinux appears to be effective for treatment of HIT patients, although large clinical trials supporting its use are lacking.
Why is fondaparinux used in HIT?
Why is fondaparinux safe in HIT?
Patients with HIT have antibodies that react with a complex of platelet factor 4 and heparin, but these antibodies appear to have minimal or no reactivity with fondaparinux.