Heparins, low-molecular-weight heparins, and pentasaccharides: use in the older patient

Age-related alterations in renal function, protein binding, and increased bleeding risk must be considered prior to administering anticoagulants to the increasing elderly population. Clinical use of unfractionated heparin, low-molecular-weight heparin, and fondaparinux are reviewed with respect to their role in prevention and treatment of venous thromboembolism, as well as for treatment of acute coronary syndrome. In addition, heparin-induced thrombocytopenia, a potentially life-threatening adverse effect, is discussed with respect to both diagnosis and management.