Parenteral anticoagulation

Parenteral anticoagulants are used for the prevention of venous thromboembolism and in the management of acute coronary syndrome.

Unfractionated heparin and low molecular weight heparin are discussed in detail so this note will focus on fondaparinux and direct thrombin inhibitors.

Fondaparinux

Activates antithrombin III, which in turn potentiates the inhibition of coagulation factors Xa. It is given subcutaneously.

Direct thrombin inhibitors

Examples include bivalirudin. These are generally given intravenously.

Dabigatran is a type of direct thrombin inhibitor that is taken orally. It is often grouped alongside the direct oral anticoagulants (DOACs).