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Issues in the utilization of low molecular weight heparins.

Publication ,  Journal Article
O'Shea, SI; Ortel, TL
Published in: Semin Hematol
July 2002

Low molecular weight heparins (LMWHs) are parenteral anticoagulants that are widely used for the prevention and treatment of thromboembolic disease. These agents possess several advantages compared to standard heparin, including a more predictable anticoagulant response, better bioavailability allowing for subcutaneous therapy, and a longer half-life. Laboratory monitoring of the LMWHs uses an anti-factor Xa assay, but monitoring is generally not necessary for most patients. However, certain patient populations do benefit from an individualized approach to therapy and, in some cases, therapeutic monitoring, because of an increased bleeding risk and/or relative contraindications to anticoagulant therapy. For example, since LMWHs are cleared by the kidney, they must be used with caution in renal insufficiency. LMWHs are safe and effective during pregnancy but may not be the optimal antithrombotic agent in pregnant women with prosthetic valves. In addition, management around the time of delivery can be difficult because of the bleeding risk, particularly associated with epidural anesthesia. Therapeutic monitoring also may be useful for the morbidly obese, in children, and for patients with malignancy.

Duke Scholars

Published In

Semin Hematol

DOI

ISSN

0037-1963

Publication Date

July 2002

Volume

39

Issue

3

Start / End Page

172 / 178

Location

United States

Related Subject Headings

  • Pregnancy
  • Male
  • Immunology
  • Humans
  • Heparin, Low-Molecular-Weight
  • Female
  • Drug Monitoring
  • Contraindications
  • Anticoagulants
  • 3201 Cardiovascular medicine and haematology
 

Citation

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O’Shea, S. I., & Ortel, T. L. (2002). Issues in the utilization of low molecular weight heparins. Semin Hematol, 39(3), 172–178. https://doi.org/10.1053/shem.2002.34090
O’Shea, Susan I., and Thomas L. Ortel. “Issues in the utilization of low molecular weight heparins.Semin Hematol 39, no. 3 (July 2002): 172–78. https://doi.org/10.1053/shem.2002.34090.
O’Shea SI, Ortel TL. Issues in the utilization of low molecular weight heparins. Semin Hematol. 2002 Jul;39(3):172–8.
O’Shea, Susan I., and Thomas L. Ortel. “Issues in the utilization of low molecular weight heparins.Semin Hematol, vol. 39, no. 3, July 2002, pp. 172–78. Pubmed, doi:10.1053/shem.2002.34090.
O’Shea SI, Ortel TL. Issues in the utilization of low molecular weight heparins. Semin Hematol. 2002 Jul;39(3):172–178.
Journal cover image

Published In

Semin Hematol

DOI

ISSN

0037-1963

Publication Date

July 2002

Volume

39

Issue

3

Start / End Page

172 / 178

Location

United States

Related Subject Headings

  • Pregnancy
  • Male
  • Immunology
  • Humans
  • Heparin, Low-Molecular-Weight
  • Female
  • Drug Monitoring
  • Contraindications
  • Anticoagulants
  • 3201 Cardiovascular medicine and haematology