WordNet

a silvery soft waxy metallic element of the alkali metal group; occurs abundantly in natural compounds (especially in salt water); burns with a yellow flame and reacts violently in water; occurs in sea water and in the mineral halite (rock salt) (同)Na, atomic number 11

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ソジウム,ナトリウム(金属元素;化学記号はNa)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/06/08 06:25:49」(JST)

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Danaparoid sodium (Orgaran) is an anticoagulant^[1] that works by inhibiting activated factor X (factor Xa).

Danaparoid is a heparinoid but considered to be a low molecular weight heparin by some sources. However it is chemically distinct from heparin, has different protein binding properties and thus has little cross-reactivity in heparin-intolerant patients.

It consists of a mixture of heparan sulfate, dermatan sulfate, and chondroitin sulfate.^[2]

Uses

It is used to prevent deep venous clots, particularly in situations with a high risk of clot formation, such as after hip surgery.

It is also used as a heparinoid substitute in heparin-induced thrombocytopenia^[3]^[4] (HIT) which may otherwise cause paradoxical thrombosis. Danaparoid is used for thrombosis prophylaxis and treatment in heparin-induced thrombocytopenia patients, although cross-reactivity with heparin-induced antibodies can occur in 10–20% of the patients (ESRA). It has been proposed for use in Kasabach-Merritt syndrome.^[5]

Discontinuation

On August 14, 2002, this drug was withdrawn by Organon International.^[6] Due to a shortage in drug substance, the manufacturer discontinued providing the medication in the United States. It is available in several other countries.^[7]

On the Schering-Plough website, Orgaran is described as "Marketed outside the U.S."^[8]

Administration

IV and SC

Side effects

Bleeding (solely restricted to patients undergoing cardio-pulmonmary surgery with by pass)<Magnani HN, Gallus AG. Heparin-induced thrombocytopenia (HIT) A report of 1478 clinical outcomes of patients treated with danaparoid (Orgaran) from 1982 to mid 2004." Thromb Haemost 2006; 95: 967-871>
Low platelets, due to a low level of structural similarity between danaparoid and heparin, i.e.only in some patients sensitive to heparin or a LMWH but to date never developed spontaneously.
possiblyAsthma exacerbations, due to allergies to sulfites contained within the medicine (no case has been reported to date).

References

^ Hagiwara S, Iwasaka H, Hidaka S, Hishiyama S, Noguchi T (2008). "Danaparoid sodium inhibits systemic inflammation and prevents endotoxin-induced acute lung injury in rats". Crit Care 12 (2): R43. doi:10.1186/cc6851. PMC 2447588. PMID 18380908.
^ de Pont AC, Hofstra JJ, Pik DR, Meijers JC, Schultz MJ (2007). "Pharmacokinetics and pharmacodynamics of danaparoid during continuous venovenous hemofiltration: a pilot study". Crit Care 11 (5): R102. doi:10.1186/cc6119. PMC 2556745. PMID 17854496.
^ Schindewolf M, Magnani HN, Lindhoff-Last E (May 2007). "[Danaparoid in pregnancy in cases of heparin intolerance - use in 59 cases]". Hamostaseologie (in German) 27 (2): 89–97. PMID 17479171.
^ Magnani HN, Gallus A (June 2006). "Heparin-induced thrombocytopenia (HIT). A report of 1,478 clinical outcomes of patients treated with danaparoid (Orgaran) from 1982 to mid-2004". Thromb. Haemost. 95 (6): 967–81. doi:10.1160/TH05-07-0489. PMID 16732376.
^ Ontachi Y, Asakura H, Omote M, Yoshida T, Matsui O, Nakao S (November 2005). "Kasabach-Merritt syndrome associated with giant liver hemangioma: the effect of combined therapy with danaparoid sodium and tranexamic acid". Haematologica. 90 Suppl: ECR29. PMID 16266920.
^ "Danaparoid (Subcutaneous Route) - MayoClinic.com". Retrieved 2007-08-23.
^ "Heparin Induced Thrombocytopenia" Uptodate www.uptodate.com retrieved on 2/6/2009
^ "Schering-Plough - Products and Care - A-Z Product Listing". Retrieved 2008-08-23.

External links

danaparoid at the US National Library of Medicine Medical Subject Headings (MeSH)

UpToDate Contents

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1. ヘパリン起因性血小板減少症 heparin induced thrombocytopenia
2. ヘパリンおよびワルファリン以外の抗凝固剤 anticoagulants other than heparin and warfarin
3. 血液透析中の抗凝固療法 hemodialysis anticoagulation
4. 急性虚血性脳卒中および一過性脳虚血発作に対する抗血栓治療 antithrombotic treatment of acute ischemic stroke and transient ischemic attack
5. 血液学の最新情報 whats new in hematology

English Journal

Argatroban: for a few selected patients.

[No authors listed]AbstractType II heparin-induced thrombocytopenia is currently managed by withdrawing heparin and replacing it with danaparoid sodium. Argatroban, a direct thrombin inhibitor anticoagulant (like lepirudin), is now authorised for this indication in France, following authorisation in several other countries since the early 2000s. Argatroban has not been compared with danaparoid in clinical trials. About 700 patients treated with argatroban in 2 trials were compared to historical controls managed by simple withdrawal of heparin and, in some cases, switching to an oral anticoagulant. Argatroban had no apparent advantages in terms of death or the need for amputation. Argatroban did not appear to increase the risk of bleeding in these trials, but evidence provided by historical comparisons is weak. The adverse effect profile includes hepatic disorders (notably fulminant hepatitis). The risk of pharmacokinetic interactions appears to below. In practice, given the absence of a proven therapeutic advantage, it is better to continue to use danaparoid for first-line treatment, reserving argatroban for the rare situations in which danaparoid is inappropriate.
Prescrire international.Prescrire Int.2013 Feb;22(135):33-5.
Type II heparin-induced thrombocytopenia is currently managed by withdrawing heparin and replacing it with danaparoid sodium. Argatroban, a direct thrombin inhibitor anticoagulant (like lepirudin), is now authorised for this indication in France, following authorisation in several other countries si
PMID 23444494

Emphysematous cystitis following a transrectal needle guided biopsy of the prostate.

Hashimoto T, Namiki K, Tanaka A, Shimodaira K, Gondo T, Tachibana M.SourceDepartment of Urology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
BMC infectious diseases.BMC Infect Dis.2012 Nov 26;12:322. doi: 10.1186/1471-2334-12-322.
BACKGROUND: Emphysematous cystitis (EC) is a comparatively rare urinary tract infection characterized by air within the bladder wall and lumen and is usually associated with immunosuppression or poorly controlled diabetes mellitus.CASE PRESENTATION: We report a case of EC in a 70-year-old man who re
PMID 23176639

Heparin-induced thrombocytopenia after cardiac surgery: an observational study of 1,722 patients.

Piednoir P, Allou N, Provenchère S, Berroeta C, Huisse MG, Philip I, Ajzenberg N.SourceUniv Paris Diderot, Sorbonne Cité, Département d'Anesthésie Réanimation, Paris, France. pascale.piednoir@bch.aphp.fr
Journal of cardiothoracic and vascular anesthesia.J Cardiothorac Vasc Anesth.2012 Aug;26(4):585-90. doi: 10.1053/j.jvca.2011.11.009. Epub 2012 Jan 20.
OBJECTIVES: To assess the characteristics and prognosis of patients in whom heparin-induced thrombocytopenia (HIT) was confirmed (HIT+) among suspected HIT patients after having cardiac surgery and to assess the accuracy of two HIT scoring systems.DESIGN: An observational prospective study.SETTING:
PMID 22265338

Japanese Journal

PD2-04 胆道閉鎖症患児に対する肝移植術後抗凝固療法 : danaparoid sodiumの使用経験(小児移植医療,パネルディスカッションII,病気の子供達に笑顔小児外科に夢そして革新を,第47回日本小児外科学会学術集会)

新開真人,大浜用克,藤田省吾,武浩志,北河徳彦,本多昌平,平田義弘,薄井佳子,永渕弘之,林拓也,森永聡一郎
日本小児外科学会雑誌 46(3), 423, 2010-05-20
NAID 110008015742

Danaparoid sodium 投与により大量腸管切除を回避できた門脈・上腸間膜静脈血栓症の1例

松橋延壽,國枝克行,山田敦子,佐々木義之,田中千弘,西科琢雄,長尾成敏,河合雅彦
日本腹部救急医学会雑誌 = Journal of abdominal emergency medicine 30(1), 65-68, 2010-01-31
NAID 10026326454

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Danaparoid
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AHFS/Drugs.com	Micromedex Detailed Consumer Information
MedlinePlus	a602007
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CAS Registry Number
ATC code	B01AB09
UNII	BI6GY4U9CW
ChEMBL	CHEMBL1201684
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