The prevention and treatment of venous thromboembolism with LMWHs and new anticoagulants
Andrew D Blann, Chee W Khoo
University Department of Medicine, City Hospital, Birmingham, UK
Abstract: As the risk factors for thrombosis are becoming better understood, so is the need for anticoagulation. The inherent difficulties with warfarin are such that a low-molecular-weight heparin (LMWH) is often the key therapeutic. However, there are several different species of LMWH available to the practitioner, which leads to the need for an objective guide. New agents are coming onto the marketplace, and these may supersede both warfarin and the heparins. The current report will review the biochemistry and pharmacology of different LWMHs and identify which are more suitable for the different presentations of venous thromboembolism. It will conclude with a brief synopsis of new agents which may supersede warfarin and heparin.
Keywords: thrombosis, warfarin, heparin, anticoagulation
Perhaps the most effective agents for the prevention and treatment of blood clots in veins of the leg (DVT) and the lungs (PE) are a group of drugs called low molecular weight heparin. This article explains what the particular drugs in this group are, how they work, and who can be treated by them. It also draws attention to new drugs, which can be given by mouth (a considerable step forward since heparin must be injected), and which may take over from the heparins in a number of conditions.
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