Low Molecular Weight Heparin Flashcards

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1
Q

Give an example of a LMWH

A

Enoxaparin

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2
Q

What is the mechanism of action of LMWB?

A

Bind to anti-thrombin to form a complex which inactivates clotting factor Xa, which prevents clot formation and reduces VTE risk

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3
Q

What is the route of delivery of LMWH?

A

SC

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4
Q

What are the indications for LMWH?

A
  • Prophylaxis and treatment of VTE and PE

- MI and unstable ACS

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5
Q

What are the contraindications to LMWH?

A
  • Thrombocytopenia

- Anticoagulant use

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6
Q

What might patients with renal impairment require with LMWH?

A

Dose adjustment

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7
Q

Who should LMWH be used with caution in?

A
  • Elderly patients
  • Patients with hepatic impairment
  • Low body weight
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8
Q

What should be done before starting treatment with LMWH?

A
  • Measure FBC (platelets) and U&Es (potassium) before starting treatment
  • Calculate creatinine clearance
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9
Q

Why should you calculate creatinine clearance before starting treatment with LMWH?

A

To ensure patients renal function is appropriate for dose they will be prescribed - if <30ml/min, should be prescribed half dose

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10
Q

What should be done if there is a change in the renal function of a patient on LMWH?

A

The dose should be reviewed

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11
Q

What should be done if thrombocytopenia occurs in a patient on LMWH?

A

Discontinue

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12
Q

What might LMWH interact with?

A
  • NSAIDs
  • Anticoagulants
  • Antiplatelet drugs
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13
Q

What are the common side effects of LMWH?

A
  • Haemorrhage

- Heparin-induced thrombocytopenia

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14
Q

What are the less common side effects of LMWH?

A
  • Hypersensivity and injection site reactions
  • Skin necrosis
  • Hyperkalaemia
  • Alopecia
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15
Q

What counselling is required with LMWH?

A
  • Indication and duration
  • Injection technique
  • Excessive bleeding
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16
Q

What is LMWH used for?

A

Temporarily in the first few days of warfarin therapy, before warfarin starts to work

17
Q

What counselling is required regarding injection technique with LMWH?

A

Teach patient how to self-inject LMWH and emphasise rotation of injection sites