plcros.blogg.se - Lovenox antidote

In Davis' drug guide for nurses (11th ed., pp. Salem, MA: AHA.ĭeglin, J.H., & Vallerand, A.H. Low molecular weight heparin (e.g., enoxaparin) is preferred for unstable angina and NSTEMI over unfractionated heparin.Īmerican Heart Association. Monitor injection sites for signs of hematoma.Īpply direct pressure to venipuncture sites for longer durations (e.g., 3 minutes). Monitor periodically CBC for blood counts.Īssess urine and stool for signs of blood. Only routes of administration are IV or SQ (does not absorb PO IM causes hematoma) Protamine sulfate is the antidote for enoxaparin.

Drug Incompatibilities: Primarily given SQ.

Drug Interactions: 1) Aspirin, NSAIDS, oral anticoagulants, and anti-platelet drugs may increase the risk of bleeding 2) feverfew, ginkgo, ginger, garlic, and horse chestnut may increase the risk of bleeding 3) Protamine sulfate is an antagonist to enoxaparin (1 mg protamine for every mg of enoxaparin).

Subcutaneous: (for DVT and other uses) 30 mg SQ BID (pulmonary embolism) 1 mg/kg SQ BID.

Intravenous: (for ACS only) 30 mg IV bolus followed by 1 mg/kg SQ BID for up to 8 days.

Safety in pregnancy (category B) or children not established Use with caution in patients who are having lumbar puncture or regional anesthesia Recent intracranial, intraspinal, or eye surgery

Thrombocytopenia (platelet count < 100,000) including idiopathic thrombocytopenic purpura (ITP)Īctive bleeding disorders (GI bleeding, peptic ulcer) Neurological injury for persons undergoing spinal canal procedures (spinal puncture, epidural anesthesia) Hypersensitivity (rash, urticaria), fever, arthralgia, angioedema Treatment of DVT with or without pulmonary embolism Prevention of DVT following surgery or during prolonged bedrest

Inactivate clotting factor Xa, blocking the conversion of prothrombin to thrombin General Principles of Hemodynamic Monitoring.Systemic Inflammatory Response Syndrome.Instrinsic Pathway of Coagulation Cascade.Circulation of Blood through the Heart (Anatomical Pathway).Vaughan Williams Classification of Antidysrhythmic Drugs.Principles of Administration of Cardiac Medications.Because fatal reactions, often resembling anaphylaxis, have been reported with protamine sulfate, it should be given only when resuscitation equipment and treatment of anaphylactic shock are readily available. Administration of protamine sulfate can cause severe hypotensive and anaphylactoid reactions. Particular care should be taken to avoid overdosage with protamine sulfate. Neutralization of enoxaparin by protamine Time Since LOVENOX DoseĪ second infusion of 0.5 mg protamine per 1 mg LOVENOX may be administered if the aPTT measured 2 to 4 hours after the first infusion remains prolonged. Attending physicians confronted with a potential overdosage of enoxaparin should always use their best clinical judgment in determining the appropriate dosing regimen of protamine to be administered. In the event that prompt reversal of the anticoagulant effects of enoxaparin is required at any time after LOVENOX dosing, the following table is provided as a guide for initial use of protamine. Anti-factor Xa activity is never completely neutralized (maximum about 60%). However, even with higher doses of protamine, the aPTT may remain prolonged to a greater extent than usually seen with unfractionated heparin. This effect may be largely neutralized by slow intravenous injection of protamine sulfate. The anticoagulant effect of LOVENOX is inhibited by protamine. In more serious cases, protamine should be administered. LOVENOX should be immediately discontinued, at least temporarily, in cases of significant excess dosage. Accidental overdosage following administration of LOVENOX (enoxaparin) may lead to hemorrhagic complications.