Answer: Fondaparinux is a chemically synthesized version of the active pentasaccharide subunit of heparin, but it does not interact with platelet factor 4, and can be used in the management of HIT. Also, there is no need to monitor coagulation parameters. If needed, the drug level can be measured though. It can be a good agent for use on an outpatient basis. It can be used on a long term basis like in a pregnant patient. Despite its ease of use and other advantages, it is not considered the first line of treatment in HIT. The three major drawbacks with its use are
- long half-life of 17 hours
- renal excretion, and
- no antidote
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