Antithrombin activator
- Accelerates antithrombin ~1000-fold → inactivates thrombin and/or factor Xa
- Anticoagulation → bleeding risk
- Chain length decides the target: long chains reach thrombin, short chains favor Xa
- Bleeding risk; immune-mediated thrombocytopenia
Drugs with this mechanism (3)
- Enoxaparin — Low-molecular-weight heparin; predictable kinetics, anti-Xa monitoring if needed.
- Fondaparinux — Synthetic indirect factor-Xa inhibitor; useful when heparin-induced thrombocytopenia is suspected.
- Heparin — Unfractionated antithrombin potentiator; monitored by aPTT, reversed by protamine.
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