Heparins, low-molecular-weight heparins, and pentasaccharides: use in the older patient.
Age-related alterations in renal function, protein binding, and increased bleeding risk must be considered prior to administering anticoagulants to the increasing elderly population. Clinical use of unfractionated heparin, low-molecular-weight heparin, and fondaparinux are reviewed with respect to their role in prevention and treatment of venous thromboembolism, as well as for treatment of acute coronary syndrome. In addition, heparin-induced thrombocytopenia, a potentially life-threatening adverse effect, is discussed with respect to both diagnosis and management.
Dinwoodey
Danya L
DL
Section of Cardiology, Boston University School of Medicine, 88 East Newton Street, C-8, Boston, MA 02118, USA.
Ansell
Jack E
JE
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001120:Arginine / Q000031:analogs & derivatives; D017984:Enoxaparin / Q000008:administration & dosage / Q000627:therapeutic use; D000077425:Fondaparinux; D006493:Heparin / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006629:Hirudins / Q000008:administration & dosage; D006801:Humans; D010875:Pipecolic Acids / Q000008:administration & dosage / Q000627:therapeutic use; D011134:Polysaccharides / Q000008:administration & dosage / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000008:administration & dosage; D013449:Sulfonamides
D000925:Anticoagulants; D017984:Enoxaparin; D006495:Heparin, Low-Molecular-Weight; D006629:Hirudins; D010875:Pipecolic Acids; D011134:Polysaccharides; D011994:Recombinant Proteins; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban; D000077425:Fondaparinux; C083544:lepirudin