danaparoid

ダナパロイド

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danaparoid sodium

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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

Clinical data
AHFS/Drugs.com	Micromedex Detailed Consumer Information
MedlinePlus	a602007
Legal status	?
Identifiers
ATC code	B01AB09
UNII	BI6GY4U9CW N
ChEMBL	CHEMBL1201684 N
Chemical data
Formula	?
N (what is this?)  (verify)

Danaparoid sodium (Orgaran) is an anticoagulant 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.

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 (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.

Discontinuation

On August 14, 2002, this drug was withdrawn by Organon International.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

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

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

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のマネージメント management of heparin induced thrombocytopenia
• 2. ヘパリンおよびLMWヘパリン：用量および副作用 heparin and lmw heparin dosing and adverse effects
• 3. 血液透析中の抗凝固療法 hemodialysis anticoagulation
• 4. 静脈血栓塞栓症：抗凝固療法の開始（開始後10日間） venous thromboembolism initiation of anticoagulation first 10 days
• 5. 持続的腎代替療法中の抗凝固療法 anticoagulation for continuous renal replacement therapy

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

• Internal Medicine 55(1), 37-42, 2016
• NAID 130005116795

• 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

• 日本救命医療学会雑誌 28, 15-21, 2014
• NAID 40020262330

• 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

• 肝臓 55(10), 612-618, 2014
• NAID 130004701704

Related Links

• Untitled Document [www.mikanbox.com]

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 ...

• Danaparoid - Springer

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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