Abstract
Warfarin, heparin and their derivatives have been the traditional anticoagulants used for prophylaxis and treatment of venous thromboembolism.
While the modern clinician is familiar with the efficacy and pharmacokinetics of these agents, their adverse effects have provided the impetus for the development of newer anticoagulants with improved safety, ease of administration, more predictable pharmacodynamics and comparable efficacy. Research into haemostasis and the coagulation cascade has made the development of these newer anticoagulants possible. These drugs include the factor Xa inhibitors and IIa (thrombin) inhibitors.
Direct and indirect factor Xa inhibitors are being developed with a relative rapid onset of action and stable pharmacokinetic profiles negating the need for close monitoring; this potentially makes them a more attractive option than heparin or warfarin. Examples of direct factor Xa inhibitors include apixaban, rivaroxaban, otamixaban, betrixaban and edoxaban. Examples of indirect factor Xa inhibitors include fondaparinux, idraparinux and idrabiotaparinux.
Direct thrombin inhibitors (factor IIa inhibitors) were developed with the limitations of standard heparin and warfarin in mind. Examples include recombinant hirudin (lepirudin), bivalirudin, ximelagatran, argatroban, and dabigatran etexilate.
This review will discuss emerging novel anticoagulants and their use for the prophylaxis and management of venous thromboembolism, for stroke prevention in nonvalvular atrial fibrillation and for coronary artery disease.
Keywords: Anticoagulants, heparin, warfarin, thrombin, traditional anticoagulants, prophylaxis, venous thromboembolism, pharmacokinetics, predictable pharmacodynamics, idrabiotaparinux
Current Medicinal Chemistry
Title:Emerging Anticoagulants
Volume: 19 Issue: 20
Author(s): B. Kennedy, F. S. Gargoum, L. Kennedy, F. Khan, D. R. Curran and T. M. O’Connor
Affiliation:
Keywords: Anticoagulants, heparin, warfarin, thrombin, traditional anticoagulants, prophylaxis, venous thromboembolism, pharmacokinetics, predictable pharmacodynamics, idrabiotaparinux
Abstract: Warfarin, heparin and their derivatives have been the traditional anticoagulants used for prophylaxis and treatment of venous thromboembolism.
While the modern clinician is familiar with the efficacy and pharmacokinetics of these agents, their adverse effects have provided the impetus for the development of newer anticoagulants with improved safety, ease of administration, more predictable pharmacodynamics and comparable efficacy. Research into haemostasis and the coagulation cascade has made the development of these newer anticoagulants possible. These drugs include the factor Xa inhibitors and IIa (thrombin) inhibitors.
Direct and indirect factor Xa inhibitors are being developed with a relative rapid onset of action and stable pharmacokinetic profiles negating the need for close monitoring; this potentially makes them a more attractive option than heparin or warfarin. Examples of direct factor Xa inhibitors include apixaban, rivaroxaban, otamixaban, betrixaban and edoxaban. Examples of indirect factor Xa inhibitors include fondaparinux, idraparinux and idrabiotaparinux.
Direct thrombin inhibitors (factor IIa inhibitors) were developed with the limitations of standard heparin and warfarin in mind. Examples include recombinant hirudin (lepirudin), bivalirudin, ximelagatran, argatroban, and dabigatran etexilate.
This review will discuss emerging novel anticoagulants and their use for the prophylaxis and management of venous thromboembolism, for stroke prevention in nonvalvular atrial fibrillation and for coronary artery disease.
Export Options
About this article
Cite this article as:
Kennedy B., S. Gargoum F., Kennedy L., Khan F., R. Curran D. and M. O’Connor T., Emerging Anticoagulants, Current Medicinal Chemistry 2012; 19 (20) . https://dx.doi.org/10.2174/092986712801215847
DOI https://dx.doi.org/10.2174/092986712801215847 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
Call for Papers in Thematic Issues
Advances in Medicinal Chemistry: From Cancer to Chronic Diseases.
The broad spectrum of the issue will provide a comprehensive overview of emerging trends, novel therapeutic interventions, and translational insights that impact modern medicine. The primary focus will be diseases of global concern, including cancer, chronic pain, metabolic disorders, and autoimmune conditions, providing a broad overview of the advancements in ...read more
Approaches to the treatment of chronic inflammation
Chronic inflammation is a hallmark of numerous diseases, significantly impacting global health. Although chronic inflammation is a hot topic, not much has been written about approaches to its treatment. This thematic issue aims to showcase the latest advancements in chronic inflammation treatment and foster discussion on future directions in this ...read more
Cellular and Molecular Mechanisms of Non-Infectious Inflammatory Diseases: Focus on Clinical Implications
The Special Issue covers the results of the studies on cellular and molecular mechanisms of non-infectious inflammatory diseases, in particular, autoimmune rheumatic diseases, atherosclerotic cardiovascular disease and other age-related disorders such as type II diabetes, cancer, neurodegenerative disorders, etc. Review and research articles as well as methodology papers that summarize ...read more
Chalcogen-modified nucleic acid analogues
Chalcogen-modified nucleosides, nucleotides and oligonucleotides have been of great interest to scientific research for many years. The replacement of oxygen in the nucleobase, sugar or phosphate backbone by chalcogen atoms (sulfur, selenium, tellurium) gives these biomolecules unique properties resulting from their altered physical and chemical properties. The continuing interest in ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Adenosine Myocardial Perfusion Imaging
Current Medical Imaging Microcirculation and NO-CO Studies of a Natural Extracellular Hemoglobin Developed for an Oxygen Therapeutic Carrier
Current Drug Discovery Technologies Body Mass Index, Lipid Metabolism and Estrogens: Their Impact on Coronary Heart Disease
Current Medicinal Chemistry Hypoxia-Inducible Factor-1 in Arterial Disease: A Putative Therapeutic Target
Current Vascular Pharmacology Reducing the Risk of Major Elective Non-cardiac Surgery: Is there a Role for Levosimendan in the Preoperative Optimization of Cardiac Function?
Current Drug Targets Selective VEGFR Inhibitors for Anticancer Therapeutics in Clinical Use and Clinical Trials
Current Pharmaceutical Design The Epidemiology of Cardiovascular Disease in Adults with Type 1 Diabetes
Current Diabetes Reviews ErbB Targeted Drugs and Angiogenesis
Current Vascular Pharmacology Pathogenesis of Neointima Formation Following Vascular Injury
Cardiovascular & Hematological Disorders-Drug Targets Chronic Inflammatory Diseases: Progress and Prospect with Herbal Medicine
Current Pharmaceutical Design Fabry Disease Cardiomyopathy: from Genes to Clinical Manifestations
Current Pharmaceutical Biotechnology Targets Involved in Cardioprotection by the Non-Anesthetic Noble Gas Helium
Current Drug Targets Inflammatory Reactions and Hydrocortisone in the Setting of Cardiac Surgery: An Overview
Cardiovascular & Hematological Agents in Medicinal Chemistry Nitric Oxide and Cardiovascular Dysfunction in Sepsis
Endocrine, Metabolic & Immune Disorders - Drug Targets Diagnosis and Management of Hypertensive Emergencies Complicating Pregnancy
Current Women`s Health Reviews MRI Contrast Agents: Current Status and Future Perspectives
Anti-Cancer Agents in Medicinal Chemistry Pharmacological Properties and Therapeutic Potential of Naringenin: A Citrus Flavonoid of Pharmaceutical Promise
Current Pharmaceutical Design Are Sex Differences in Outcomes of Patients with ACS from Observational Registries Similar to the Findings from Randomized Clinical Trials?
Current Pharmaceutical Design Carbon Monoxide: Medicinal Chemistry and Biological Effects
Current Medicinal Chemistry Recent Progress on the Discovery of NLRP3 Inhibitors and their Therapeutic Potential
Current Medicinal Chemistry