PHAR 451 Lecture Notes - Lecture 18: Venous Stasis, Fondaparinux, Enoxaparin Sodium
10 Dec 2016
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Endothelial injury (abnormalities of surfaces in contact with blood) Pain and/or tenderness, swelling, warm to touch, change in colour. Sob, increased rr, chest pain, cough, increased hr. Risk of vte in pregnancy = 29/10,000. Risk of vte in peri-partum period 300-400/10,000. Drospirenone = 34d generation oc (desogestrel, gestodene) Vte risk highest in 1st few months of oc use. Stop oc for >4 weeks increased risk when re-initiated. Switching oc after <4 week break does not influence risk. Prevent acute morbidity and mortality of an acute event. 3 main types of underlying pathophysiology that cause venous thrombosis. Ufh/lmwh/fonda x 5 days (minimum) and until inr >2 x 48 hrs. It takes a few days until all clotting factors are inhibited (each have different half-lives) Baseline inr then daily until stabilized inr 2-3. More convenient less lab monitoring, single daily sc administration, outpatient administration. Preferred in pts with very poor renal function (crcl <30 = cut off point)
