Pharmacology
Mechanism of action
Enoxaparin binds to and potentiates antithrombin (a circulating anticoagulant) to form a complex that irreversibly inactivates clotting factor Xa. It has less activity against factor IIa (thrombin) compared to unfractionated heparin (UFH) due to its low molecular weight. Pharmacokinetics
Absorption: Bioavailability (subcutaneous injection) ~ 100%Distribution: Volume of distribution (anti-Factor Xa activity) = 4.3 litersMetabolism: Enoxaparin is metabolized in the liver into low molecular weight species by either or both desulfation and depolymerization.Elimination: A single dose of a subcutaneous injection of enoxaparin has an elimination half-life of 4.5 hours. Approximately 10–40% of the active and inactive fragments from a single dose are excreted by the kidneys. Dose adjustments based on kidney function are necessary in persons with reduced kidney function. Drug class
Enoxaparin belongs to the class of drugs known as low molecular weight heparins. Other drugs in this class include dalteparin, fondaparinux and tinzaparin. Biosimilars
In September 2016, Inhixa and Thorinane were approved for use in the European Union. Thorinane was withdrawn from the market in October 2019.In March 2017, Enoxaparin BECAT, Laboratorios ROVI (Spain) obtained marketing authorization in twenty six countries in Europe. The product is now available in Europe.In October 2020, Noromby and Noromby HP, were approved for medical use in Canada.In November 2020,  and Inclunox HP were approved for medical use in Canada.In December 2020, Redesca and Redesca HP were approved for medical use in Canada. References
External links
"Enoxaparin sodium". Drug Information Portal. U.S. National Library of Medicine.
Aortopulmonary window (APW) refers to a congenital heart defect similar in some ways to persistent truncus arteriosus. Persistent truncus arteriosus involves a single valve; aortopulmonary window is a septal defect.A large number of patients with a large APW usually die within 1 year of age. It is extremely rare to find cases of APW surviving till adult age and it is still rare to surgically treat such patients who are incidentally detected in adult age because such subsets of patients invariably have associated pulmonary vascular obstructive disease in advanced stage and thus there is therapeutic dilemma to surgically correct these patients.Although cases of uncorrected APW presenting in adulthood have been reported but literature on surgically treated AP window in adult populations is limited. A rare case of successful surgical management of an incidentally detected large APW with reversible pulmonary arterial hypertension has been reported as isolated case reports. See also
Aortic window
Major aortopulmonary collateral artery, developes when native pulmonary circulation is underdeveloped

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