The following drugs are used for thrombosis prophylaxis:
- Heparin
- Pentasaccharide Fondaparinux (Arixtra®)
- Acetylsalicylic acid
- Oral anticoagulants
- Thrombin inhibitors
Note
General information on the topic of thrombosis prophylaxis can be found on the homepage on the topic: Thrombosis prophylaxis
Heparins
The first large group of anticoagulant drugs for the prevention of thromboembolism are heparins. They are used as a preventive measure during surgical interventions as well as in conservative medicine. It can also be used in cases of already existing venous thrombosis or pulmonary embolism.
Heparin is a natural anticoagulant that also occurs naturally in certain cells. These cells are basophilic granulocytes and mast cells. It binds to an anticoagulant in the body called antihrombin, forms a complex with it and thus increases its effectiveness.
This inhibits various factors in the coagulation cascade and thus prevents the formation of thrombus or initiates the lysis of thrombin (enzyme of the blood coagulation cascade). Heparins are divided into unfractionated heparins (UFH) and low-molecular-weight heparins (NMH). Low molecular weight fractionated heparins are used more frequently today because they have better bioavailability and longer duration of action than unfractionated heparins.
Examples of unfractionated heparins are : Examples of low molecular weight fractionated heparins are :
- Liquemin®,
- Calciparin®
- Clexane®,
- Mono-Emolex®,
- Fragmin®,
- Innohep®
Heparins are applied either bypassing the gastrointestinal tract (parenterally, i.e. venously) or under the skin (subcutaneously) with an injection. During pregnancy, heparin cannot act on the embryo via the bloodstream, i.e. it cannot pass through the placenta. As a result of overdose, intra- or postoperative bleeding may occur.
Heparins as a drug are obtained from animals (pig, cattle), so allergic reactions may occur. Blood platelets can also be affected and as a result their number may be too low (thrombocytopenia). A long intake can lead to bone loss.
Reversible, however, is a possible hair loss. An interaction can occur with drugs that inhibit the function of the blood platelets, so-called platelet aggregation inhibitors, so that the risk of bleeding is increased. The effect of heparin, on the other hand, is inhibited by interaction with drugs such as certain
- Antibiotics (tetracyclines),
- Medicines for allergies (antihistamines),
- Heart medication (cardiac glycosides).
The following laboratory parameters should be checked regularly during heparin therapy:
- APTT, thrombin time in therapy with unfractionated heparin
- Anit-Xa test for therapy with low-molecular-weight heparin
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