How does Enoxaparin work?

Enoxaparin is a low molecular weight heparin (LMWH) that primarily works by activating antithrombin III. Antithrombin III is a protein in the blood that helps to inhibit the formation of blood clots. When Enoxaparin binds to antithrombin III, it enhances its ability to inactivate factor Xa and, to a lesser extent, thrombin (factor IIa). This inhibition of clotting factors leads to an anticoagulant effect, thereby reducing the risk of thrombus formation in various clinical scenarios, such as during and after surgical procedures, and in the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE).

The other mechanisms listed do not accurately describe how Enoxaparin functions. For instance, while inhibiting platelet aggregation is a part of some anticoagulant therapies, Enoxaparin's primary mechanism is through the activation of antithrombin III rather than direct action on platelets. Similarly, Enoxaparin does not have a significant role in the production of thromboxane A2, a molecule involved in platelet aggregation and vascular function, nor does it block vitamin K production, which is more relevant to the action of vitamin K antagonists