μ λΆμλ ν€νλ¦° (λ¬ν νλ¦°, μλ Ήμ¬νλ¦°)
**μ λΆμλ ν€νλ¦°(LMWH)**(λ¬ν νλ¦° λ° μλ Ήμ¬νλ¦° ν¬ν¨)μ ννμ μμ μ¦(PTE) λ° λ©΄μ맀κ°μ± μ©νμ± λΉν(IMHA)κ³Ό κ°μ νμ μμ μ± ν©λ³μ¦ λ° κ³Όμκ³ μ¦νκ΅°μ μΉλ£νλ λ° μ¬μ©λλ νμκ³ μ μ λλ€. > **μμ κ²½κ³ :** νμ’ μ± νκ΄λ΄ μκ³ (DIC)μμμ μ¬μ©μ λ Όλμ μ¬μ§κ° μμΌλ©° λ μ΄μ DIC μλ°© λͺ©μ μΌλ‘ μ¬μ©λμ§ μμ΅λλ€. ν€νλ¦°μ μΆ©λΆν **ννΈλ‘¬λΉ III(AT III)**κ° μ‘΄μ¬ν λλ§ ν¨κ³Όκ° μμ΅λλ€. **μμ ν:** LMWHλ λ―ΈλΆν ν€νλ¦°(UFH)λ³΄λ€ μ½λνμ νΉμ±μ΄ μ°μνκ³ μμ©μ΄ λ μμΈ‘ κ°λ₯νμ§λ§ λΉμ©μ΄ ν¨μ¬ λΉμλλ€.
μμ© κΈ°μ : LMWH is an anticoagulant that inhibits **Factor Xa** and **thrombin**. * Compared with unfractionated heparin (UFH), LMWH has reduced anti-IIa activity relative to anti-Xa activity (ratio of anti-Xa to anti-IIa is 2-4:1 compared with UFH 1:1). * β At therapeutic doses, LMWH has minimal effect on aPTT. * β Therapeutic monitoring is performed by measuring **anti-Xa activity**.
λλ¬Ό μ’ λ³ μ©λ
- Thromboembolic complications and hypercoagulable syndromes Β· Target anti-Factor Xa activity of 0.35-0.7 IU/ml Β· SC/IV Β· variable Β· As directed Β· Doses are controversial. Requires sufficient AT III. May use constant IV infusions.
- Thromboembolic complications and hypercoagulable syndromes Β· Target anti-Factor Xa activity of 0.35-0.7 IU/ml Β· SC/IV Β· variable Β· As directed Β· Cats appear to require higher dosages of LMWH to achieve proposed therapeutic targets.
μ©λμ λ©΄ν μμ μ λ¬Έκ°λ₯Ό μν μμ μ°Έκ³ μλ£μ λλ€. νμ μ΅μ λΌλ²¨κ³Ό κ°λ³ νμμ λν΄ νμΈνμμμ€.
ν¬μ¬ κ²½λ‘
κΈκΈ°
- Bleeding disorders
- Severe renal dysfunction
μ΄μλ°μ
- Haematoma formation (if administered IM)
- Haemorrhage (especially in thrombocytopenic patients or those with DIC)
μ½λ¬Ό μνΈμμ©
- Aspirin Β· Can cause changes in coagulation status, increasing bleeding risk Β· major
- NSAIDs Β· Can cause changes in coagulation status, increasing bleeding risk Β· major
- ACTH Β· Heparin may antagonize ACTH Β· moderate
- Corticosteroids Β· Heparin may antagonize corticosteroids Β· moderate
- Insulin Β· Heparin may antagonize insulin Β· moderate
- Diazepam Β· Heparin may increase plasma levels of diazepam Β· moderate
- Antihistamines Β· May partially counteract the actions of heparin Β· minor
- Digoxin Β· May partially counteract the actions of heparin Β· minor
- Tetracyclines Β· May partially counteract the actions of heparin Β· minor
λͺ¨λν°λ§
- Anti-Factor Xa activity (target 0.35-0.7 IU/ml)
- aPTT (Activated partial thromboplastin time)
- PT (Prothrombin time)
- Fibrin degradation products
- Fibrinogen
- Clinical signs of bleeding
κ³Όμ©λ
If an overdosage occurs, **protamine** can be used as an antidote.
VetSheet μ½λ¬Ό λ νΌλ°μ€λ λ©΄ν μμ μ λ¬Έκ°λ₯Ό μν μμ μμ¬κ²°μ 보쑰 λꡬμ΄λ©°, μ λ¬Έμ νλ¨μ΄λ μ μ‘°μ¬μ μ΅μ λΌλ²¨μ λμ νμ§ μμ΅λλ€.