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）』「2016/01/10 12:31:27」(JST)

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Fondaparinux (trade name Arixtra) is an anticoagulant medication chemically related to low molecular weight heparins. It is marketed by GlaxoSmithKline. A generic version developed by Alchemia is marketed within the US by Dr. Reddy's Laboratories.

Structure and mechanism

Fondaparinux is a synthetic pentasaccharide factor Xa inhibitor. Apart from the O-methyl group at the reducing end of the molecule, the identity and sequence of the five monomeric sugar units contained in fondaparinux is identical to a sequence of five monomeric sugar units that can be isolated after either chemical or enzymatic cleavage of the polymeric glycosaminoglycans heparin and heparin sulfate (HS). Within heparin and heparin sulfate this monomeric sequence is thought to form the high-affinity binding site for the anti-coagulant factor antithrombin III (ATIII). Binding of heparin/HS to ATIII has been shown to increase the anti-coagulant activity of antithrombin III 1000 fold. In contrast to heparin, fondaparinux does not inhibit thrombin.

Administration

Fondaparinux is given subcutaneously daily. Clinically, it is used for the prevention of deep vein thrombosis in patients who have had orthopedic surgery as well as for the treatment of deep vein thrombosis and pulmonary embolism.

Comparison to other agents

One potential advantage of fondaparinux over LMWH or unfractionated heparin is that the risk for heparin-induced thrombocytopenia (HIT) is substantially lower. Furthermore, there have been case reports of fondaparinux being used to anti-coagulate patients with established HIT as it has no affinity to PF-4. However, its renal excretion precludes its use in patients with renal dysfunction.

Unlike direct factor Xa inhibitors, it mediates its effects indirectly through antithrombin III, but unlike heparin, it is selective for factor Xa.^[1]

Uses

Fondaparinux is similar to enoxaparin in reducing the risk of ischemic events at nine days, but it substantially reduces major bleeding and improves long-term mortality and morbidity.^[2]

It has been investigated for use in conjunction with streptokinase.^[3]

Chemical structure

Abbreviations

GlcNS6S = 2-deoxy-6-O-sulfo-2-(sulfoamino)-α-D-glucopyranoside
GlcA = β-D-glucopyranuronoside
GlcNS3,6S = 2-deoxy-3,6-di-O-sulfo-2-(sulfoamino)-α-D-glucopyranosyl
IdoA2S = 2-O-sulfo-α-L-idopyranuronoside
GlcNS6SOMe = methyl-O-2-deoxy-6-O-sulfo-2-(sulfoamino)-α-D-glucopyranoside

The sequence of monosaccharides is D-GlcNS6S-α-(1,4)-D-GlcA-β-(1,4)-D-GlcNS3,6S-α-(1,4)-L-IdoA2S-α-(1,4)-D-GlcNS6S-OMe, as shown in the following structure:

References

^ "Medscape.com". Retrieved 2009-01-23.
^ "NEJM -- Comparison of Fondaparinux and Enoxaparin in Acute Coronary Syndromes". Retrieved 2009-01-23.
^ Peters RJ, Joyner C, Bassand JP, et al. (February 2008). "The role of fondaparinux as an adjunct to thrombolytic therapy in acute myocardial infarction: a subgroup analysis of the OASIS-6 trial". Eur. Heart J. 29 (3): 324–31. doi:10.1093/eurheartj/ehm616. PMID 18245119.

External links

Arixtra home page
Alchemia home page

UpToDate Contents

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1. Fondaparinux: Dosing and adverse effects
2. 静脈血栓塞栓症の患者における理論的根拠と無期限の抗凝固の適応 rationale and indications for indefinite anticoagulation in patients with venous thromboembolism
3. 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
4. ST上昇型心筋梗塞における抗凝固療法 anticoagulant therapy in acute st elevation myocardial infarction
5. 外科患者における静脈血栓塞栓症の予防 prevention of venous thromboembolic disease in surgical patients

English Journal

Fatal pulmonary embolism complicating a postoperative chylothorax despite adequate thromboprophylaxis.

Hoskote SS, Devarapally SR, Dasgupta R, Pang Y, Shapiro JM.SourceaDepartment of Medicine bDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine cDepartment of Pathology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York, USA.
Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis.Blood Coagul Fibrinolysis.2013 Dec;24(8):887-9. doi: 10.1097/MBC.0b013e3283626266.
Chylothorax is a recognized complication of intrathoracic surgery, but its occurrence after coronary artery bypass grafting (CABG) is very rare. We report a case of a fatal pulmonary embolism as a complication of chylothorax following CABG. The patient was an 82-year-old woman who presented with inc
PMID 23751608
PMID 24219333

The use of novel oral anticoagulants for thromboprophylaxis after elective major orthopedic surgery.

Rachidi S, Aldin ES, Greenberg C, Sachs B, Streiff M, Zeidan AM.SourceDepartment of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA.
Expert review of hematology.Expert Rev Hematol.2013 Dec;6(6):677-95. doi: 10.1586/17474086.2013.853430.
Venous thromboembolism is a common cause of morbidity and mortality among patients undergoing elective orthopedic surgery. Due to the high incidence of venous thromboembolism in this setting, perioperative anticoagulation is the recommended approach for thromboprophylaxis. Low molecular weight hepar
PMID 24219550

Japanese Journal

人工膝関節全置換術におけるフォンダパリヌクス使用量に関する比較検討

小嶋秀治,原憲司,江黒日出男,黒田浩司
関東整形災害外科学会雑誌 42(3), 173-177, 2011-06-01
NAID 10028213132

大腿骨近位部骨折術後の深部静脈血栓症予防におけるエノキサパリンナトリウムとフォンダパリヌクスの比較

廣野大介,手島隆志,杉谷大造,保坂泰介,元津康彦,高田秀彰
中部日本整形外科災害外科学会雑誌. 中部日本整形外科災害外科学会抄録 54(3), 485-486, 2011-05-01
NAID 10029072238

Related Pictures

★リンクテーブル★

リンク元	「フォンダパリヌクス」「フォンダパリナックスナトリウム」

「フォンダパリヌクス」

Fondaparinux
Clinical data
Trade names	Arixtra
AHFS/Drugs.com	monograph
Licence data	EMA:Link, US FDA:link
Legal status	UK: POM (Prescription only); US: ℞-only;
Routes of; administration	subcutaneous
Pharmacokinetic data
Bioavailability	N/A
Protein binding	94%
Metabolism	renally excreted unchanged
Biological half-life	17-21 hours
Identifiers
CAS Number	114870-03-0
ATC code	B01AX05
PubChem	CID: 636380
DrugBank	DB00569
ChemSpider	552174
UNII	J177FOW5JL
ChEMBL	CHEMBL1201202
Chemical data
Formula	C31H43N3Na10O49S8
Molecular mass	1726.77 g/mol
	InChI InChI=1S/C31H53N3O49S8.10Na/c1-69-27-9(33-85(48,49)50)13(37)17(6(74-27)3-71-88(57,58)59)76-31-22(83-91(66,67)68)16(40)21(24(81-31)26(43)44)79-29-10(34-86(51,52)53)19(82-90(63,64)65)18(7(75-29)4-72-89(60,61)62)77-30-15(39)14(38)20(23(80-30)25(41)42)78-28-8(32-84(45,46)47)12(36)11(35)5(73-28)2-70-87(54,55)56;;;;;;;;;;/h5-24,27-40H,2-4H2,1H3,(H,41,42)(H,43,44)(H,45,46,47)(H,48,49,50)(H,51,52,53)(H,54,55,56)(H,57,58,59)(H,60,61,62)(H,63,64,65)(H,66,67,68);;;;;;;;;;/q;10*+1/p-10/t5-,6-,7-,8-,9-,10-,11-,12-,13-,14-,15-,16+,17-,18-,19-,20+,21+,22-,23+,24-,27+,28-,29-,30-,31-;;;;;;;;;;/m1........../s1 ; Key:XEKSTYNIJLDDAZ-JASSWCPGSA-D ;
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　　[★]

英: fondaparinux
同: フォンダパリナックス
化: fondaparinux sodium フォンダパリヌクスナトリウム、フォンダパリナックスナトリウム
商: アリクストラ
関: 血液凝固阻止剤

抗血栓薬

特徴

構造

作用機序

ATIIIに高親和性に結合してATIIIの抗第Xa因子活性を増強させる
第Xa因子活性：↓
抗トロンビン活性：↓

薬理作用

抗菌スペクトル

動態

適応

注意

禁忌

副作用

「フォンダパリナックスナトリウム」

　　[★]

英: fondaparinux sodium
関: フォンダパリヌクス、フォンダパリヌクスナトリウム

[1] "Medscape.com". Retrieved 2009-01-23.

[urlNEJM_--_Comparison_of_Fondaparinux_and_Enoxaparin_in_Acute_Coronary_Syndromes-2] "NEJM -- Comparison of Fondaparinux and Enoxaparin in Acute Coronary Syndromes". Retrieved 2009-01-23.

[pmid18245119-3] Peters RJ, Joyner C, Bassand JP, et al. (February 2008). "The role of fondaparinux as an adjunct to thrombolytic therapy in acute myocardial infarction: a subgroup analysis of the OASIS-6 trial". Eur. Heart J. 29 (3): 324–31. doi:10.1093/eurheartj/ehm616. PMID 18245119.

匿名

検索

案内

案内

fondaparinux sodium