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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/01/31 20:40:04」(JST)
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Danaparoid
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| Clinical data |
| AHFS/Drugs.com |
Micromedex Detailed Consumer Information |
| MedlinePlus |
a602007 |
| Legal status |
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| Identifiers |
| ATC code |
B01AB09 |
| UNII |
BI6GY4U9CW N |
| ChEMBL |
CHEMBL1201684 N |
| Chemical data |
| Formula |
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| N (what is this?) (verify) |
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]
Contents
- 1 Uses
- 2 Discontinuation
- 3 Administration
- 4 Side effects
- 5 References
- 6 External links
Uses[edit]
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[edit]
On August 14, 2002, this drug was withdrawn by Organon International.[6] Due to a shortage in drug substance, the manufacturer discontinued providing the medication in the United States.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[edit]
IV and SC
Side effects[edit]
- 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[edit]
- ^ 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[edit]
- danaparoid at the US National Library of Medicine Medical Subject Headings (MeSH)
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Antithrombotics (thrombolytics, anticoagulants and antiplatelet drugs) (B01)
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| Antiplatelet drugs |
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Glycoprotein IIb/IIIa inhibitors
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- Abciximab
- Eptifibatide
- Tirofiban
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ADP receptor/P2Y12 inhibitors
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- thienopyridines
- Clopidogrel
- Prasugrel
- Ticlopidine
- nucleotide/nucleoside analogs
- Cangrelor
- Elinogrel
- Ticagrelor
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Prostaglandin analogue (PGI2)
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- Beraprost
- Iloprost
- Prostacyclin
- Treprostinil
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COX inhibitors
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- Acetylsalicylic acid/Aspirin#
- Aloxiprin
- Carbasalate calcium
- Indobufen
- Triflusal
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Thromboxane inhibitors
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- thromboxane synthase inhibitors
- Dipyridamole (+Aspirin)
- Picotamide
- receptor antagonist
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Phosphodiesterase inhibitors
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- Cilostazol
- Dipyridamole
- Triflusal
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Other
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| Anticoagulants |
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Vitamin K antagonists
(inhibit II, VII, IX, X)
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- coumarins: Acenocoumarol
- Coumatetralyl
- Dicoumarol
- Ethyl biscoumacetate
- Phenprocoumon
- Warfarin#
- 1,3-Indandiones: Clorindione
- Diphenadione
- Phenindione
- other: Tioclomarol
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Factor Xa inhibitors
(with some II inhibition)
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Heparin group/
glycosaminoglycans/
(bind antithrombin) |
- low molecular weight heparin
- Bemiparin
- Certoparin
- Dalteparin
- Enoxaparin
- Nadroparin
- Parnaparin
- Reviparin
- Tinzaparin
- oligosaccharides
- heparinoid
- Danaparoid
- Dermatan sulfate
- Sulodexide
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Direct Xa inhibitors
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- xabans
- Apixaban
- Betrixaban
- Darexaban
- Edoxaban
- Otamixaban
- Rivaroxaban
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Direct thrombin (II) inhibitors
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- bivalent: Hirudin
- Bivalirudin
- Desirudin
- Lepirudin
- univalent: Argatroban
- Dabigatran
- Melagatran‡
- Ximelagatran‡
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Other
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- Antithrombin III
- Defibrotide
- Protein C
- Ramatroban
- REG1
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Thrombolytic drugs/
fibrinolytics |
- plasminogen activators: r-tPA
- Alteplase
- Reteplase
- Tenecteplase
- UPA
- Anistreplase
- Monteplase
- Streptokinase#
- other serine endopeptidases: Ancrod
- Brinase
- Fibrinolysin
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| Non-medicinal |
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- #WHO-EM
- ‡Withdrawn from market
- Clinical trials:
- †Phase III
- §Never to phase III
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cell/phys (coag, heme, immu, gran), csfs
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rbmg/mogr/tumr/hist, sysi/epon, btst
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drug (B1/2/3+5+6), btst, trns
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UpToDate Contents
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English Journal
- Current management of heparin-induced thrombocytopenia.
- Cosmi B1.
- Expert review of hematology.Expert Rev Hematol.2015 Sep 14:1-13. [Epub ahead of print]
- Heparin-induced thrombocytopenia (HIT) is an immune adverse reaction to heparin (both unfractionated and low-molecular-weight), which is mediated by the formation of IgG antibodies against platelet factor 4-heparin complexes. The IgG/platelet factor 4 immunocomplexes activate platelets with resultin
- PMID 26368591
- Combination of 4Ts score and PF4/H-PaGIA for diagnosis and management of heparin-induced thrombocytopenia: prospective cohort study.
- Linkins LA1, Bates SM1, Lee AY2, Heddle NM3, Wang G3, Warkentin TE4.
- Blood.Blood.2015 Jul 30;126(5):597-603. doi: 10.1182/blood-2014-12-618165. Epub 2015 Apr 29.
- Rapid exclusion of heparin-induced thrombocytopenia (HIT) is needed to determine which patients can continue to receive heparin. In this prospective management study, 526 participants had a 4Ts score, rapid particle gel immunoassay (platelet factor 4/heparin [PF4/H]-PaGIA), and serotonin-release ass
- PMID 25926600
- CLINICAL PRACTICE. Heparin-Induced Thrombocytopenia.
- Greinacher A.
- The New England journal of medicine.N Engl J Med.2015 Jul 16;373(3):252-61. doi: 10.1056/NEJMcp1411910.
- PMID 26176382
Japanese Journal
- Paralytic Ileus due to Superior Mesenteric Venous Thrombosis after Transarterial Injection for Hepatocellular Carcinoma
- 臨床研究 敗血症性DICに対するrecombinant Thrombomodulinの効果 : Danaparoid Sodiumとの比較検討
- 肝静脈の段階的な血栓化により肝不全死したBudd-Chiari症候群の1例
Related Links
- 商品名はオルガラン（danaparoid sodium）、本邦で承認済みである。注射剤（1mlに1250単位を含む）である。投与法は1回1250単位を12時間ごとに靜注する。上述のように半減期が長いので、持続点滴の必要がないためである。1 汎発 ...
- Abstract Danaparoid (danaparoid sodium) is a low molecular weight heparinoid which has undergone clinical study for use as continued anticoagulant therapy in patients with heparin-indu ... ORGARAN (danaparoid sodium). Japanese ...
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