Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and Review
The purpose of this article is to report a case of fondaparinux outpatient utilization for anticoagulation in a patient with a past medical history of heparin-induced thrombocytopenia (HIT) and discuss the options and need for future anticoagulation research in this unique patient population. A 63-y...
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Format: | Article |
Language: | English |
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MDPI AG
2016-12-01
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Series: | Pharmacy |
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Online Access: | http://www.mdpi.com/2226-4787/5/1/1 |
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author | Amy Christopher |
author_facet | Amy Christopher |
author_sort | Amy Christopher |
collection | DOAJ |
description | The purpose of this article is to report a case of fondaparinux outpatient utilization for anticoagulation in a patient with a past medical history of heparin-induced thrombocytopenia (HIT) and discuss the options and need for future anticoagulation research in this unique patient population. A 63-year-old Caucasian female with a previous medical history of HIT thromboprophylaxed with warfarin for a pulmonary embolism presented to an anticoagulation clinic with a subtherapeutic international normalized ratio (INR) after missed warfarin doses. The patient was instructed to increase her warfarin dose and was prescribed fondaparinux daily injections until her INR was in range. The patient tolerated the fondaparinux therapy without thromboembolic, thrombocytopenia or bleeding occurrence. Fondaparinux therapy for HIT is controversial and differs between established guidelines. Currently, there is no studied use of fondaparinux for thromboprophylaxis in warfarin therapy outpatients with a HIT history who need thromboprophylaxis while undergoing therapy for a procedure, or those who have a subtherapeutic INR. Further study of the outpatient use of fondaparinux for this patient subset is needed to explore the potential benefit of an outpatient, less invasive, less expensive and potentially better tolerated option. |
first_indexed | 2024-04-11T18:19:35Z |
format | Article |
id | doaj.art-2a995cfbebba41f48347f002309e41d7 |
institution | Directory Open Access Journal |
issn | 2226-4787 |
language | English |
last_indexed | 2024-04-11T18:19:35Z |
publishDate | 2016-12-01 |
publisher | MDPI AG |
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series | Pharmacy |
spelling | doaj.art-2a995cfbebba41f48347f002309e41d72022-12-22T04:09:48ZengMDPI AGPharmacy2226-47872016-12-0151110.3390/pharmacy5010001pharmacy5010001Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and ReviewAmy Christopher0Anticoagulation Clinic, St. Elizabeth Healthcare, 1 Medical Village Drive, Edgewood, KY 41017, USAThe purpose of this article is to report a case of fondaparinux outpatient utilization for anticoagulation in a patient with a past medical history of heparin-induced thrombocytopenia (HIT) and discuss the options and need for future anticoagulation research in this unique patient population. A 63-year-old Caucasian female with a previous medical history of HIT thromboprophylaxed with warfarin for a pulmonary embolism presented to an anticoagulation clinic with a subtherapeutic international normalized ratio (INR) after missed warfarin doses. The patient was instructed to increase her warfarin dose and was prescribed fondaparinux daily injections until her INR was in range. The patient tolerated the fondaparinux therapy without thromboembolic, thrombocytopenia or bleeding occurrence. Fondaparinux therapy for HIT is controversial and differs between established guidelines. Currently, there is no studied use of fondaparinux for thromboprophylaxis in warfarin therapy outpatients with a HIT history who need thromboprophylaxis while undergoing therapy for a procedure, or those who have a subtherapeutic INR. Further study of the outpatient use of fondaparinux for this patient subset is needed to explore the potential benefit of an outpatient, less invasive, less expensive and potentially better tolerated option.http://www.mdpi.com/2226-4787/5/1/1anticoagulationheparin-induced thrombocytopeniafactor-Xa inhibitorsnovel oral anticoagulantswarfarinperiprocedural anticoagulationsubtherapeutic anticoagulation |
spellingShingle | Amy Christopher Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and Review Pharmacy anticoagulation heparin-induced thrombocytopenia factor-Xa inhibitors novel oral anticoagulants warfarin periprocedural anticoagulation subtherapeutic anticoagulation |
title | Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and Review |
title_full | Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and Review |
title_fullStr | Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and Review |
title_full_unstemmed | Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and Review |
title_short | Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and Review |
title_sort | fondaparinux outpatient use for patients with a heparin induced thrombocytopenia history a case report and review |
topic | anticoagulation heparin-induced thrombocytopenia factor-Xa inhibitors novel oral anticoagulants warfarin periprocedural anticoagulation subtherapeutic anticoagulation |
url | http://www.mdpi.com/2226-4787/5/1/1 |
work_keys_str_mv | AT amychristopher fondaparinuxoutpatientuseforpatientswithaheparininducedthrombocytopeniahistoryacasereportandreview |