CHAPTER 26 – DRUGS AFFECTING THROMBOSIS AND HAEMOSTASIS

Question 1

Mrs AJ, a 63-year-old woman, has been admitted to the local hospital following a fall while out walking her dog. After examination and radiological assessment, she undergoes surgery for a hip replacement and returns to the ward at 11pm. The following morning at 7am she is commenced on Fondaparinux 2.5mg subcutaneously once daily, which continued for the next 8 days while she remained in hospital. The orthopaedic surgeon advises Mrs AJ that the drug will be continued until she is fully mobile.

Answer 1

Mrs AJ, a 63-year-old woman, has been admitted to the local hospital following a fall while out walking her dog. After examination and radiological assessment, she undergoes surgery for a hip replacement and returns to the ward at 11pm. The following morning at 7am she is commenced on Fondaparinux 2.5mg subcutaneously once daily, which continued for the next 8 days while she remained in hospital. The orthopaedic surged advises Mrs AJ that the drug will be continued until she is fully mobile.

Question 2

1. Discuss the mechanism of action of Fondaparinux and explain why Mrs AJ was commenced on this drug postoperatively

Answer 2

Fondaparinux works by inhibiting one of the steps necessary for the formation of blood clots, which help prevent clots from developing or worsening

Question 3

2. Explain why Fondaparinux was not administered until the following morning

Answer 3

It was prescribed after as it is used in preventing blood clots (DVT) in patients who have certain types of surgeries and specifically treats blood clots in the lungs and legs. It is administered no earlier than 6-8 hours after surgery as if done prior could increase the risk of major bleeding occurring.

Question 4

3. Discuss the rationale for keeping Mrs AJ on the drug until she is fully mobile

Answer 4

It is given to Mrs AJ until she is fully mobile as the risk of DVT are increased due to her not being able to move about freely