Ver el código de «Low molecular weight heparin»

==Background==
A class of anticoagulant medications.  These drugs are used for treating deep vein thrombosis, pulmonary embolism when it is located in the veins, or heart attacks and strokes when located in the arteries.   LMWHs cannot be acceptably measured using the partial thromboplastin time (PTT) or activated clotting time (ACT) tests. Rather, LMWH therapy is monitored by the anti-factor Xa assay, measuring anti-factor Xa activity.

LMWHs are defined as heparin salts having an average molecular weight of less than 8000 Dalton. LMWHs inhibit the coagulation process through binding to antithrombin which in turn inhibition  activated factor X.<ref>Garcia DA, Baglin TP, Weitz JI, et al. (2012). "Parenteral anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines"</ref>

==Types==
{| class="wikitable"
|-
! LMWH !! Average molecular weight !! Ratio anti-Xa/anti-IIa activity
|-
| [[Bemiparin]] || 3600 || 8.0
|-
| [[Nadroparin]] || 4300 || 3.3
|-
| [[Reviparin]] || 4400 || 4.2
|-
| [[Enoxaparin]] (Lovenox) || 4500 || 3.9
|-
| [[Parnaparin]] || 5000 || 2.3
|-
| [[Certoparin]] || 5400 || 2.4
|-
| [[Dalteparin]] || 5000 || 2.5
|-
| [[Tinzaparin]] || 6500 || 1.6
|-
|}

==Clinical Differences from [[Unfractionated heparin]]==
* Less frequent subcutaneous dosing
* Once or twice daily subcutaneous injection for treatment of venous thromboembolism and in unstable angina instead of intravenous infusion of high dose heparin.
* No need for monitoring of the [[APTT]] coagulation parameter as required for high dose heparin.<ref>http://chestjournal.chestpubs.org/content/119/1_suppl/64S.full</ref>
* Possibly a smaller risk of [[bleeding]].
* Smaller risk of [[osteoporosis]] in long-term use.
* Smaller risk of [[heparin-induced thrombocytopenia]], a potential side effect of [[heparin]].
* The anticoagulant effects of heparin are typically reversible with [[protamine sulfate]], while protamine's effect on LMWH is limited.

==Indications==
*[[DVT]]
*[[PE]]
*[[NSTEMI]]
*[[STEMI]]

==See Also==
*[[Heparin (Unfractionated)]]
*[[Coagulopathy (Main)]]

==Source ==
<references/>

[[Category:Drugs]]
[[Category:Heme/Onc]]