ANTIDOTE FOR LOVENOX MANUAL
ANTIDOTE FOR LOVENOX SKIN
ANTIDOTE FOR LOVENOX FREE

Blood for the plasma heparin assay (Hepa) should be taken at 4 hours after the administration of the 0200 dose only. Enoxaparin should be dosed at standard times (02).To coordinate the Plasma Heparin Assay (Hepa), subsequent dosing and preparation of final dilution. Procedure for Enoxaparin Dosing, Plasma Heparin Assay (Hepa) and Preparation of Dosage Form

ANTIDOTE FOR LOVENOX FREE

for doses greater than, or equal to, 5mg and up to 10mg, the dose will be rounded to the nearest mg and will be supplied in syringes as the undiluted, preservative free product (5mg / 0.05mL).if the dose is less than 5mg, then the dose is rounded to the nearest 0.5mgand supplied by Pharmacy in a 30unit Insulin syringe (each gradient of 1unit is equal to 1mg of enoxaparin).enoxaparin cannot be used interchangeably (unit for unit) with unfractionated heparin or other LMWHs as the actions, molecular weight distributions, units, and doses differ 6.replacement of the Insuflon catheter is recommended every 3 to 4 days the catheter must not remain in place for greater than 7 days.after the drug has been administered, flush the Insuflon catheter with 0.02mL of 0.9% NaCl to account for the dead space.use an indwelling SC catheter (Insuflon catheter) to minimize injections-refer to Insuflon policy.

must be administered subcutaneously (SC).enoxaparin (LOVENOX ©) has 110 anti-factor Xa units / mg.therapeutic range of anti-factor Xa level : 0.5 - 1.0 units / mL.it is suggested that the anti-factor Xa level be drawn on day 1 and/or day 2, and after a therapeutic level is achieved, weekly monitoring is normally sufficient 9.adjust dose according to anti-factor Xa levels taken 4 to 6 hours after SC dose (sample collection should be done at the mid-interval between doses 0.45 mL of blood is the minimum volume required in a DIC screen tube notify lab prior to obtaining sample).enoxaparin has a 96 hour automatic stop order (ASO) and must be reordered every 96 hours unless the order specifies a duration of treatment.avoid IM injections and arterial punctures during anticoagulation 9.Hold all doses until antifactor Xa is 0.5 units/mL, then decrease dose by 40%īefore next dose and every 12 h until antifactor Xa <0.5 units/mL platelets, occult blood and anti-Xa activity the monitoring of PT and/or PTT is not necessary 11.

ANTIDOTE FOR LOVENOX SKIN

hypersensitivity: thrombocytopenia, skin rash, and anaphylactoid reactions are rare but occur with all LMWH 6 (not reported in neonates).

liver: caused asymptomatic elevations of liver enzymes in 6% of adult patients 6.

minor bleeding (at the Insuflon injection site, oozing from central venous line (CVL), gastric tubes and abscess sites) occurred in 17% of patients receiving enoxaparin therapy 5.

These bleeds consisted of: gastrointestinal bleeds, intracranial bleeds, and thigh haematomas (at Insuflon injection sites) 5

major bleeds occurred in 4% of 173 children (1 day of age to 18 years old).

peak plasma anti-Xa levels appear 3 to 5 hours after the SC injection of enoxaparin 4,11.

cleared by the kidneys (small amounts of the drug are eliminated in the intact or slightly degraded form) 4.

weakly metabolized in the liver by desulfation and depolymerization 4.

enoxaparin (as well as other LMWHs) catalyses the inactivation of Factor Xa by antithrombin III.

commercially available LMWHs have molecular weights that vary from 4,000 to 6,000 (regular heparin consists of a mixture of molecules whose molecular weights range from 5,000 to 30,000) 8.

enoxaparin is a low molecular weight heparin (LMWH) fragment that possesses anticoagulant action 2.the treatment of thrombotic disease, deep vein thrombosis (DVT), and pulmonary embolisms(PE) 1.Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

ANTIDOTE FOR LOVENOX MANUAL

If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. The information contained within the Manual may not be applicable to other centres. This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution.

Antidote for lovenox