Faculty
Joseph F. Dasta, MSc., FCCM, FCCP
College of Pharmacy The Ohio State University
Steven M. Hollenberg, MD
Robert Wood Johnson Medical School/ UMDNJ-Camden
Sandra L. Kane-Gill, PharmD., MSc.
University of Pittsburgh School of Pharmacy
Arthur P. Wheeler, MD
Vanderbilt University School of Medicine
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Release date: November 15, 2005
Accreditation expired
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Program
Description
Anticoagulants
are used in a wide variety of patients, for both therapeutic purposes and as
prophylaxis against thromboembolism. The efficacy of these agents has been well
established in clinical trials. |
| Unfractionated heparin can be
hard to use, it binds to plasma proteins, and so there is wide variation in its
anticoagulant effect. Vigilant monitoring of the PTT is
necessary. Heparin-induced thrombocytopenia occurs about 3% of the time
and this can be a big problem when it occurs. |
Low molecular weight heparins are
produced by depolymerization of unfractionated heparin, rendering them smaller
and thus more bioavailable. There is less binding to plasma proteins and
less inactivation by platelet factor 4. Because of their more predicable
effects, routine laboratory monitoring for dose adjustment is usually not
required. |
There are solid clinical trial
data indicating that low molecular weight heparins can be used as an
alternative to unfractionated heparins. This program’s intention is NOT to
review those data. Instead, this program features a discussion between
four experts in critical care medicine. The discussion addresses the
challenges in dosing and monitoring patients at the extremes of body weight,
patients with renal insufficiency, and critically ill patients with altered
plasma volume. |
Target
Audience
This
activity is intended for Cardiologists, Hematologists, Intensivists,
Pharmacists and other healthcare professionals who treat patients with LMWH. |
Educational
Objectives
Upon
completion of this activity, participants will be able to:
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Maximize safety and efficacy
while reducing harm when dosing LMWH.
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Identify dosing considerations
in special populations (i.e. critically ill, obese, renal impaired).
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Have a greater understanding of
the pharmaco-economics surrounding LMWH.
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Disclaimer
©2005
Scinexa, LLC. All rights reserved. None of the contents may be reproduced in
any form without prior written permission from Scinexa.
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The views and opinions expressed
in this activity are those of the faculty. They do not reflect the views of
Sanofi-Aventis, any other manufacturer of pharmaceuticals, ArcMesa Educators,
or Scinexa, LLC. |
The recommendations made in this
program are based upon a combination of randomized clinical trials, current
guidelines, and the clinical practice experience of the participating
panelists. Any medications, diagnostic procedures or treatments discussed by
the panelists should not be utilized without evaluation of their patient's
conditions. Participants are urged to consult the full prescribing information
on any drug mentioned in this activity for recommended dosage, indications,
contraindications, warnings, precautions, and adverse effects before
prescribing any medication.
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