Is fondaparinux a Pentasaccharide?
Fondaparinux (Arixtra), a synthetic pentasaccharide, is the first in a new class of antithrombotic agents that selectively inhibit coagulation factor Xa. In vitro expts. demonstrated that it is a selective inhibitor of factor Xa.
What is the best antidote for fondaparinux?
Contrary to UFH or LMWHs, fondaparinux is not neutralized by protamine sulfate, and no antidote is available to counteract bleeding disorders associated with overdosing. To make the use of fondaparinux safer, we developed an antithrombin (AT) variant as a potent antidote to heparin derivatives.
What is a Pentasaccharide?
The pentasaccharides are completely synthetic compounds that bind to and potentiate the effect of ATIII in blocking factor Xa. They are derived from the five-saccharide effector site found on molecules of heparin but, like LMWH, are too small to form the ternary complex.
What is Pentasaccharide sequence?
This pentasaccharide sequence selectively binds to anti-thrombin, resulting in enhanced effects of anti-thrombin on factor Xa. The structure of pentasaccharide sequence is shown in Figure 2.
When do you stop taking fondaparinux?
Depending on the patient’s renal function, fondaparinux should be discontinued 36 to 42 hours before any procedure that carries the risk of hemorrhage, or before spinal anesthesia (Table 1) (8).
Can fondaparinux cause thrombocytopenia?
It seems plausible that anti-PF4/heparin antibodies generated through previous exposure to fondaparinux resulted in a clinical syndrome of HIT. The rapidity of thrombocytopenia with thrombosis suggests an anamnestic response to preformed anti-PF4/heparin antibodies upon exposure to enoxaparin.
Is fondaparinux reversible?
Fondaparinux. No specific antidote exists for fondaparinux reversal. Prohemostatic agents such as rFVIIa and activated PCC have been shown to reverse anticoagulant action of fondaparinux, although clinical data are largely limited to in vitro studies.
Which drug is synthetic Pentasaccharide used as anticoagulant?
Fondaparinux, a synthetic pentasaccharide, is a selective antithrombin-dependent factor Xa inhibitor. As with LMWH, fondaparinux is less biologically variable and does not need monitoring of its anticoagulant effect.
Does fondaparinux require monitoring?
Fondaparinux is an alternative agent for patients with contraindications for UFH and LMWH. It has the advantage of no routine monitoring in adult patients and once- or twice-daily administration. However, in special populations, monitoring is necessary.
When should I take fondaparinux?
Administer the initial dose no earlier than 6 to 8 hours after surgery. Administration of ARIXTRA earlier than 6 hours after surgery increases the risk of major bleeding. The usual duration of therapy is 5 to 9 days; up to 11 days of therapy was administered in clinical trials.
How do I monitor fondaparinux?
Laboratory monitoring of Fondaparinux is possible by utilizing factor Xa inhibitory activity of the drug. Anti-Xa assay (used for monitoring heparin) is modified by using a standard curve constructed with Fondaparinux. frozen) within 3 hours of collection.
Does fondaparinux cause thrombocytopenia?
Does fondaparinux cause hyperkalemia?
Fondaparinux was definitively used, and potassium returned to normal values (Fig. 1c). These cases demonstrate that severe hyperkalemia can occur in association with prophylactic doses of enoxaparin. Hyperkalemia is a rare (2.4 %) [2] but well-documented side-effect of LMWH [3, 4].