[New anticoagulants in clinical practice].
The current management of thrombotic and vascular disorders has been strongly influenced by the introduction of several new drugs. 1. One of the major impact in the management of venous thromboembolic disorders has been the LMWHs. The newest, third generation heparin, the pentasaccharide inhibits specifically FXa. The elimination half-life of pentasaccharide is about 17 h, which allows a convenient once-daily dosing regime. The effects of pentasaccharide needs antithrombin. 2. Melagatran dipeptid is a specific, reversible direct thrombin inhibitor. It inhibits free and clot bound thrombin. Ximelagatran is a prodrug of melagatran. It is the first clinically used orally acting direct thrombin inhibitor. 3. Recombinant human activated protein C (rh-APC) has some advantages in patients with septic DIC. Qualities of the three new anticoagulants and clinical experiences with them have been summarized.
Boda
Zoltán
Z
Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Belgyógyászati Intézet, II. Belgyógyászati Klinika, Haemostaseologiai Tanszék. zboda@jaguar.unideb.hu
D000925:Anticoagulants / Q000627:therapeutic use*; D001384:Azetidines / Q000627:therapeutic use; D001596:Benzylamines; D000077425:Fondaparinux; D005998:Glycine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D011134:Polysaccharides / Q000627:therapeutic use; D011486:Protein C / Q000627:therapeutic use; D011655:Pulmonary Embolism / Q000188:drug therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D020246:Venous Thrombosis / Q000188:drug therapy
D000925:Anticoagulants; D001384:Azetidines; D001596:Benzylamines; D011134:Polysaccharides; D011486:Protein C; D011994:Recombinant Proteins; C109573:melagatran; C426686:ximelagatran; D000077425:Fondaparinux; C421124:drotrecogin alfa activated; D005998:Glycine