Update on heparin: what do we need to know?
Over the last 15 years, there has been a shift from unfractionated heparin to low-molecular-weight heparin or fondaparinux for many indications. Nonetheless, heparin continues to be used and it remains the drug of choice for selected indications and patients. This paper reviews when and how to use heparin and when low-molecular-weight heparin or fondaparinux may be a better choice. The paper also describes some of the new parenteral anticoagulants under development and provides perspective on how the introduction of rapid-acting oral thrombin or factor Xa inhibitors is likely to reduce or eliminate the need for bridging with parenteral anticoagulants.
Weitz
Daniel S
DS
Department of Medicine, McMaster University, and Henderson Research Centre, Hamilton, ON, Canada.
Weitz
Jeffrey I
JI
D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006470:Hemorrhage / Q000139:chemically induced; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D018579:Patient Selection; D018570:Risk Assessment; D013921:Thrombocytopenia / Q000139:chemically induced; D013927:Thrombosis / Q000517:prevention & control*; D016896:Treatment Outcome
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006493:Heparin