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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/01/28 17:35:27」(JST)

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Dalteparin is a low molecular weight heparin. It is marketed as Fragmin by Pfizer Inc. Like other low molecular weight heparins, dalteparin is used for prophylaxis or treatment of deep vein thrombosis and pulmonary embolism. It is normally administered by self-injection.

The CLOT study, published in 2003, showed that in patients with malignancy and acute venous thromboembolism, dalteparin was more effective than warfarin in reducing the risk of recurrent embolic events.^[1] Dalteparin is not superior to unfractionated heparin in preventing blood clots.^[2]

Heparins are cleared by the kidneys, but studies have shown that dalteparin does not accumulate even if kidney function is reduced.^[3]

References

^ Lee AY, Levine MN, Baker RI, Bowden C, Kakkar AK, Prins M, Rickles FR, Julian JA, Haley S, Kovacs MJ, Gent M (2003). "Low-molecular-weight heparin versus a Coumadin for the prevention of recurrent venous thromboembolism in patients with cancer". N Engl J Med 349 (2): 146–53. doi:10.1056/NEJMoa025313. PMID 12853587.
^ The PROTECT Investigators for the Canadian Critical Care Trials Group and the Australian and New Zealand Intensive Care Society Clinical Trials Group (2011). "Dalteparin versus unfractionated heparin in critically ill patients". doi:10.1056/NEJMoa1014475.
^ Douketis J, Cook D, Meade M et al. (2008). "Prophylaxis against deep vein thrombosis in critically ill patients with severe renal insufficiency with the low-molecular-weight heparin dalteparin". Arch Intern Med 168 (16): 1805–1812. doi:10.1001/archinte.168.16.1805. PMID 18779469.

UpToDate Contents

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1. 静脈血栓塞栓症に対する低分子ヘパリン low molecular weight heparin for venous thromboembolic disease
2. 最新の診療アップデート practice changing updates
3. 悪性腫瘍患者における静脈血栓塞栓症の治療 treatment of venous thromboembolism in patients with malignancy
4. 非ST上昇型急性冠症候群における抗凝固療法 anticoagulant therapy in non st elevation acute coronary syndromes
5. 急性発症した入院内科患者における静脈血栓塞栓症の予防 prevention of venous thromboembolic disease in acutely ill hospitalized medical adults

English Journal

Recurrence of Venous Thromboembolism in Patients With Cancer Treated With Warfarin.

Marshall AL1, Campigotto F2, Neuberg D2, Rowe B3, Connors JM4.
Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis.Clin Appl Thromb Hemost.2015 Oct;21(7):632-8. doi: 10.1177/1076029615579099. Epub 2015 Apr 7.
Venous thromboembolism (VTE) is a common complication in patients with cancer. Previous randomized studies have demonstrated that the rates of recurrent VTE are lower in patients treated with low-molecular-weight heparin compared to warfarin. We performed a retrospective analysis of 236 patients wit
PMID 25850917

Venous thromboembolism: identifying patients at risk and establishing prophylaxis.

Tapson VF1, Shirvanian S1.
Current medical research and opinion.Curr Med Res Opin.2015 Sep 28:1-64. [Epub ahead of print]
Venous thromboembolism (VTE) is a major cause of morbidity and mortality and is associated with substantial health care costs. Identification of patients at risk of developing VTE enables appropriate thromboprophylaxis to be implemented. Although no predisposing risk factors can be identified in man
PMID 26414590

Updates in pediatric venous thromboembolism.

Gillespie MA1, Lyle CA, Goldenberg NA.
Current opinion in hematology.Curr Opin Hematol.2015 Sep;22(5):413-9. doi: 10.1097/MOH.0000000000000168.
PURPOSE OF REVIEW: The occurrence of pediatric venous thromboembolism (VTE) and the associated sequelae are increasing. The purpose of this PubMed-based review was to summarize the evidence published between 1 August 2014 and 31 March 2015 regarding pediatric VTE epidemiology, risk factors and risk
PMID 26203734

Japanese Journal

下肢静脈エコー検査で術前診断した下肢静脈血栓症を有する開頭術症例での低分子量ヘパリンの経験

高田大慶,永井秀政,小割健太郎,大洲光裕,杉本圭司,秋山恭彦,田中延子,濱田千津子,山口修平
神経超音波医学 = Neurosonology : official journal of Japan Academy of Neurosonology 23(1), 23-26, 2010-04-30
… She was administered LMWH (dalteparin) perioperatively, and underwent open craniotomy without pulmonary accident. …
NAID 10027726428

低分子量ヘパリン薬(ダルテパリン)を併用した川崎病治療法開発の予備的検討

稲毛康司,大島暢,齊藤勝也 [他],長谷川真紀,林利佳,阿部修,石川央朗,吉野弥生,橋本光司,渕上達夫,宮下理夫,金丸浩,鮎沢衛,麦島秀雄
日大醫學雜誌 68(1), 11-15, 2009-02-01
NAID 10024923321

Effects of Bemiparin, Dalteparin, and Unfractionated Heparin on Platelet Interaction With Human Subendothelium Under Flow Conditions

Gonzalez-Correa Jose Antonio,Arrebola Maria Monsalud,Merida Francisco [他],NAVAS Maria Dolores,LOPEZ-VILLODRES Juan Antonio,SAMANES Felisa,DE LA CRUZ Jose Pedro
Journal of pharmacological sciences 107(1), 103-106, 2008-05-20
… We compared the effects of the low-molecular-weight heparin (LMWH), bemiparin, and dalteparin with unfractionated heparin (UFH) on the platelet subendothelium interaction under flow conditions. …
NAID 10024320651

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★リンクテーブル★

リンク元	「ダルテパリン」
拡張検索	「dalteparin sodium」

「ダルテパリン」

Dalteparin sodium
Clinical data
Trade names	Fragmin
AHFS/Drugs.com	International Drug Names
Legal status	?
Identifiers
CAS number	9041-08-1
ATC code	B01AB04
DrugBank	DB06779
KEGG	D03353
Chemical data
Formula	?