Critical Care Medicine MCQs (Answer): 46. Correct Answer is B. A 46-year-old man with hypertension and focal segmental glomerulosclerosis with a baseline creatinine of 3.3 mg/dL presents with a left lower extremity deep vein thrombosis. He weighs 82 kg. Rationale:Fondaparinux is a direct factor Xa inhibitor that is a synthetic analogue of the pentasaccharide sequence found in heparin. A smaller compound than either unfractionated heparin or low-molecular-weight heparin (LMWH), fondaparinux acts by binding antithrombin and catalyzing factor Xa inhibition. At only 5 polysaccharide units, fondaparinux is too small to bridge antithrombin to thrombin and does not potentiate thrombin inhibition. Fondaparinux is given by the subcutaneous route and has 100% bioavailability without plasma protein binding. Like LMWH, it has a predictable anticoagulant effect and monitoring of factor Xa levels is not required. It is excreted unchanged in the urine. Fondaparinux is absolutely contraindicated in those with a creatinine clearance of
Posted on: Tue, 13 Aug 2013 04:20:22 +0000
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