Enoxaparin

Enoxaparin /Clexane                     preg risk C

Indications/actions: Prevention of pulmonary embolism and deep vein thrombosis(hip or knee surgery)/low molecular weight heparin. Interfere with the normal cascade of events involved in the clotting process.

Surgery, injury, prolonged bed rest, prescribed by weight. Admin- SC. The bubble in the prefilled syringe, ensures that the full dose and the bubble stays in the syringe.

Adverse:

CNS: confusion, neurological injury when used with spinal or epidural puncture, fever, pain

CV: oedema, peripheral oedema, CV toxicity(chest pain, dizziness,irregular heartbeat)

GI: nausea

Haematologic: hypochromic anaemia, thrombocytopenia, haemorrhage, ecchymoses; bleeding complicaitons.

Skin: rash hives

Drug-drug: anticoagulants, drugs that alter platelet function(salycilates)

Contraindications: hypersensitivity, major bleeding or thrombocytopenia.

Care considerations: use extreme caution when hx of heparin induced thrombocytopenia(HIT), aneurysms, cerebrovascular haemorrhage, uncontrolled hypertension or threatened abortion.;use cautiously in elderly, any one at risk from haemorrhage, eg ulcer disease, haemorrhagic stroke

Alerts:

·         Never administer IM.

·         Keep bubble in syringe

·         Do not massages site after SC injection, rotate sites, watch for bleeding at sites.

·         Monitor for bleeding gums, bruises on arms or legs, petechiae, nosebleeds, tarry stools, haematuria and haematemesis.

·         Monitor INR, platelet counts

·         Give protamine sulfate(heparin antagonist) in severe overdose.

·         Drug may increase platelet count, AST, and ALT

·         Avoid during lactation