lmwh การใช้

• Warfarin and LMWH may safely be used in breastfeeding.
• For those with cancer LMWH is recommended.
• However, the effects of natural, or unfractionated heparin are more unpredictable than LMWH.
• LMWH can also be used to maintain the patency of cannulae and shunts in dialysis patients.
• The first'generic'LMWH was approved by the Food and Drug Administration in July 2010.
• Low molecular weight heparin ( LMWH, such as enoxaparin ) is generally used as an alternative.
• When the commercial patent of a LMWH expires, a generic or biosimilar LMWH can then be marketed.
• When the commercial patent of a LMWH expires, a generic or biosimilar LMWH can then be marketed.
• With LMWH and fondaparinux, the risk of osteoporosis and heparin-induced thrombocytopenia ( HIT ) is reduced.
• Given its renal clearance, LMWH may not be feasible in patients that have end-stage renal disease.
• Similar issues are likely associated with the use of enoxaparin ( a LMWH ) in these high-risk individuals.
• The use of LMWH needs to be monitored closely in patients at extremes of weight or in-patients with renal dysfunction.
• Hence a slight change in the depolymerisation process could result in substantial variation of the structure or composition of a given LMWH.
• The incidence is difficult to estimate but may reach up to 5 % of patients treated with UFH or about 1 % with LMWH.
• According to international guidelines, the choice of an individual LMWH should be based on its proven clinical safety and efficacy for each indication.
• The FDA has used 5 analytical and pharmacological criteria to establish the authenticity of a generic LMWH, without requiring clinical studies in patients.
• This risk can be reduced by a daily subcutaneous injection of low-molecular-weight heparin ( LMWH ) until the surgical drain is removed.
• Multiple pharmacological therapies for DVT were introduced in the 20th century : oral anticoagulants in the 1940s, subcutaneous LDUH in 1962 and subcutaneous LMWH in 1982.
• These quality assurance steps, to be effective, need to be implemented from the raw material ( crude heparin ) collection to the final LMWH product.
• Therefore, for every LMWH, a strictly defined depolymerisation procedure is needed to guarantee the sameness of the final LMWH product and the predictability of clinical outcomes.