Dalteparin

Enoxaparin sodium Dalteparin sodium Tinzaparin Nadroparin sodium Ardepatrin Benzylation followed by alkaline depolymerization Nitrous acid depolymerization Enz3miatic depolymerization with heparinase Nitrous acid depolymerization Peroxidative depolymerization... 

The Heparin in Acute Embolic Stroke Trial (HAEST) was a multicenter, randomized trial of the effect of LMWH (dalteparin 100 lU/kg sc twice daily) or aspirin (160 mg once daily) for the acute treatment of 449 patients with ischemic stroke and atrial fibrillation (AF). The primary outcome was the rate of recurrent stroke within 14 days. No difference in rates of early recurrence (8.5% dalteparin treated vs. 7.5% aspirin treated) or good 3-month functional outcome was found. The frequency of early slCH was 2.7% on dalteparin versus 1.8% on aspirin. 

Dalteparin 200 units/kg SQ daily for 1 mo, followed by 150 units/kg SQ daily thereafter... 

Dalteparin or tinzaparin—1 mg protamine/100 units dalteparin or tinzaparin to a maximum of 50 mg... 

Dose may depend on the lapsed time after LMWH administration (e.g., 0.5 mg protamine per 100 units dalteparin or tinzaparin to a maximum of 50 mg if >8 h has passed since the last administered dose)... 

Dalteparin 120 lU/kg SC every 12 hours (maximum single bolus dose of 10,000 units)... 

Moderate Major or minor surgery, age 40-60 years, and no clinical risk factors Major surgery, age less than 40 years, and no clinical risk factors Minor surgery, with clinical risk factor(s) Acutely ill (e.g., myocardial infarction, ischemic stroke, heart failure exacerbation), and no clinical risk factors 10-20 1-2 I o UFH 5000 units SC every 12 hours Dalteparin 2500 units SC every 24 hours Enoxaparin 40 mg SC every 24 hours Tinzaparin 3500 units SC every 24 hours IPC Graduated compression stockings... 

The most extensively studied drugs for the prevention of VTE are unfractionated heparin (UFH), the low-molecular-weight heparins (LMWHs dalteparin, enoxaparin, and tinza-parin), fondaparinux, and warfarin.2 The LMWHs and fondaparinux provide superior protection against VTE when... 

Dalteparin 6 200 units/kg SC once daily or 100 units/kg SC twice daily... 

Dalteparin (Fragmin) 100 units/kg every 12 hours or 200 units/kg every 24 hours... 

Low-molecular-weight heparin (average MW -5000) has a longer duration of action and needs to be given only once daily (e.g., certoparin, dalteparin, enoxaparin, reviparin, tinzaparin). 

Pharmacology Enoxaparin, tinzaparin, and dalteparin are LMWHs. These agents enhance the inhibition of Factor Xa and thrombin by binding to and accelerating antithrombin activity. They preferentially potentiate the inhibition of Factor Xa, while only slightly affecting thrombin and clotting time (activated partial thromboplastin time [APTT] or PT). 

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