LOW MOLECULAR WEIGHT HEPARIN

ANTICOAGULATION IS VERY ESSENTIAL IN MANAGEMENT OF ACUTE CORONARY SYNDROME. (ANTICOAGULATION = MAKING THE BLOOD THINNER THAN USUAL) IT HAS BEEN SHOWN TO IMPROVE MORTALITY AND MORBIDITY. PREVIOUSLY WE USED UNFRACTIONATED HEPARIN (UFH) AS AN INFUSION FOR ABOUT 48 HOURS. THE DRUG ITSELF IS VERY CHEAP. HOWEVER, IT REQUIRES INFUSION PUMP AND CLOSE MONITORING APTT (A MEASUREMENT OF THE DEGREE OF THINNING OF BLOOD).

THEN THE LOW MOLECULAR WEIGHT HEPARIN (LMWH) CAME INTO PICTURE. THE ATTRACTIVENSS IS THAT IT IS ONLY GIVEN AS SUBCUTANEOUS INJECTION (LIKE INSULIN) TWICE A DAY FOR TOTAL OF 6 DOSES. ENOXAPARIN (CLEXANE), ONE OF THE LMWH HAS BEEN SHOWN TO BE MORE SUPERIOR THAN UFH. THE PROBLEM IS THAT THE EARLIER GENERATION LMWH IS PORCINE BASED. THIS MAY NOT BE VERY PLEASING TO THE EARS OF MUSLIMS...

RECENTLY GLAXOSMITHKLINE PRODUCED A NEW ANTICOAGULATION, FONDAPARINUX (ARIXTRA) WHICH IS NOT PORCINE BASED. ARIXTRA HAS BEEN SHOWN TO BE SUPERIOR THAN LMWH IN REDUCING FURTHER MORTALITY AND MORBIDITY IN ACUTE CORONARY SYNDROME. IT IS GIVEN AS ONCE DAILY SUBCUTANEOUS INJECTION FOR 3 DAYS.

SO PLEASE ASK YOUR DOCTOR REGARDING THE CHOICES OF ANTICOAGULATION.