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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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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419381/ https://www.ncbi.nlm.nih.gov/pubmed/28970413 http://dx.doi.org/10.3390/pharmacy5010001 |
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author | Christopher, Amy |
author_facet | Christopher, Amy |
author_sort | Christopher, Amy |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-5419381 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-54193812017-09-29 Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and Review Christopher, Amy Pharmacy (Basel) Case Report 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. MDPI 2016-12-22 /pmc/articles/PMC5419381/ /pubmed/28970413 http://dx.doi.org/10.3390/pharmacy5010001 Text en © 2016 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Christopher, Amy Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and Review |
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 | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419381/ https://www.ncbi.nlm.nih.gov/pubmed/28970413 http://dx.doi.org/10.3390/pharmacy5010001 |
work_keys_str_mv | AT christopheramy fondaparinuxoutpatientuseforpatientswithaheparininducedthrombocytopeniahistoryacasereportandreview |