Canonical Question

Full Table: Heparin vs. Enoxaparin

V5 N4.i Historical V4 Q2.i 1 appearance

Master answer

Heparin

Binds to, and stabilizes anti-thrombin 3-thrombin complex
- → Potentiates the degradation of thrombin (does not occur with LMW heparins)
Also aids antithrombin 3 degradation of factors IX and X (major function of LMW heparins)

		HEPARIN	ENOXAPARIN
PK	A	Subcut or IV administration	Subcut administration
	A	~90% bioavailability SC due to tissue binding	>95% bioavailability SC – NOT bound in tissues
	D	5% protein bound	5% protein bound
	D	V_d – 0.3l/kg	V_d – 0.3l/kg
	M	Heparinases	Minimal metabolism
	E	Renal elimination of inactive metabolites	Renal elimination of unchanged drug Dosage adjustment required in renal failure
	E	T_1/2b ~2 hours	T_1/2b 4~6 hours
Monitoring		APTT, activated clotting time	Anti-Xa assay (expensive, time-consuming)
Adverse Effects		Bleeding	Bleeding
		Heparin induced thrombocytopoenia	Less likely to develop HITS
		Osteoporosis	Less likely to develop Osteoporosis
Reversal		Reversal with protamine sulfate	Partial (40%) reversal with protamine sulfate

Sakurai 2016

Answer by Sakurai

Exam appearances

Exam	Exact wording	Relationship	Success
2008A Q02	Outline the differences between heparin and enoxaparin with respect to: a. Phamacokinetics b. Monitoring of effect c. Adverse effects d. Reversal of effect	historical_member	33.00%