heparin and LMWH

1. HARINI PRIYADHARSHINI . M

2. DRUGS THAT REDUCE THE COAGULABILITY
(ABILITY TO COAGULATE) OF BLOOD

3.  Muco polysaccharide found in the mast cells of
liver, intestine and lungs.
 Strongest acid in the body
 It is a powerful anticoagulant that acts instantaneously
both in vivo and in vitro.

4. Heparin activates Anti
thrombin III which inhibits
activated thrombin and
coagulation factors.

5.  Not effective orally.
 When given Intra muscularly it may cause hematomas.
 It is normally given IV or SC.
 Heparin is metabolised by heparinase in the liver.

6.  Bleeding
 Hypersensitivity
 Heparin induced thrombocytopenia
 Reversible alopecia
 Osteoporosis
 Hyperaldosteronism

7.  Bleeding disorders.
 Heparin induced thrombocytopenia
 Thrombocytopenic purpura
 Infective endocarditis.
 Threatened abortion.
 Haemophilia.

8.  Includes enoxaparin, dalteparin, reviparin, nadreparin
etc.
 LMWH has a relatively favorable pharmacokinetic
profile.
 Inhibits only factor Xa and has a weak effect on
thrombin. Thus, aPTT or clotting time are not
prolonged.
 Lower risk of osteoporosis.
 Lower risk of thrombocytopenia and thrombosis.

9.  In severe heparin overdose an antagonist may be
needed to arrest its anti coagulant effects.
Protamine sulphate is the commonly used heparin
antagonist.
Given IV, it neutralises heparin.
In the absence of heparin, protamine sulphate can act
as a weak anticoagulant itself.
 Fondaxaparinux is used for the prevention and
treatment of deep vein thrombosis and pulmonary
embolism.

10.  Heparan sulphate present in some tissues is similar to
heparin.
 Danaparoid is a mixture of heparinoids and acts by
inhibiting factor Xa.
 It is longer acting.