Which medications in the drug class Low-Molecular-Weight Heparins are used in the treatment of Wellens Syndrome?

Updated: Jan 25, 2018
  • Author: Benjamin B Mattingly, MD; Chief Editor: Erik D Schraga, MD  more...
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Answer

Low-Molecular-Weight Heparins

LMWHs inhibit thrombogenesis. LMWH differs from unfractionated heparin (UFH) in that it has a higher ratio of anti–factor Xa to anti–factor IIa. It binds to antithrombin III, enhancing its therapeutic effect. The heparin-antithrombin III complex binds to and inactivates activated factor X (Xa) and factor II (thrombin). It does not actively lyse but is able to inhibit further thrombogenesis. It prevents reaccumulation of clot after spontaneous fibrinolysis.

Enoxaparin (Lovenox)

Enoxaparin is an LMWH produced by partial chemical or enzymatic depolymerization of UFH. Its advantages include intermittent dosing and a decreased requirement for monitoring. Heparin anti-Xa levels may be obtained if needed to establish adequate dosing. There is no utility in checking the activated partial thromboplastin time (aPTT), because the drug has a wide therapeutic window and aPTT does not correlate with anticoagulant effect. Maximal anti-Xa and antithrombin activities occur 3-5 hours after administration.

Enoxaparin is indicated for treatment of acute ST-segment elevation MI (STEMI) managed either medically or with subsequent PCI. It is also indicated for prophylaxis of ischemic complications caused by unstable angina and non-Q-wave MI.


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