Anticoagulants: fondaparinux: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Anticoagulants: fondaparinux

Sample item

A patient who developed heparin-induced thrombocytopenia needs a subcutaneous anticoagulant that selectively inhibits factor Xa through antithrombin and is not neutralised by protamine. Which drug fits?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Fondaparinux

Fondaparinux is a synthetic pentasaccharide that binds antithrombin and selectively inhibits factor Xa. It does not cross-react with heparin antibodies and is not reversed by protamine. It is cleared by the kidney and is avoided in severe renal impairment.

Option by option

  • A. Dabigatran

    Dabigatran is an oral direct thrombin inhibitor.

  • B. Enoxaparin

    Enoxaparin is a heparin and may cross-react in HIT.

  • C. Warfarin

    Warfarin is oral and acts on vitamin K dependent factors.

  • D. Fondaparinux (correct)

    Correct. A synthetic pentasaccharide with selective Xa inhibition.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Fondaparinux. Fondaparinux is a synthetic pentasaccharide that binds antithrombin and selectively inhibits factor Xa.

Why is "Dabigatran" not the answer?

Dabigatran is an oral direct thrombin inhibitor.

Why is "Enoxaparin" not the answer?

Enoxaparin is a heparin and may cross-react in HIT.

Why is "Warfarin" not the answer?

Warfarin is oral and acts on vitamin K dependent factors.

What concept does this question test?

It tests Anticoagulants: fondaparinux in Pharmacology. It does not cross-react with heparin antibodies and is not reversed by protamine. It is cleared by the kidney and is avoided in severe renal impairment.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Anticoagulants: fondaparinux?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.