Low Molecular Weight Heparin Flashcards
Give an example of a LMWH
Enoxaparin
What is the mechanism of action of LMWB?
Bind to anti-thrombin to form a complex which inactivates clotting factor Xa, which prevents clot formation and reduces VTE risk
What is the route of delivery of LMWH?
SC
What are the indications for LMWH?
- Prophylaxis and treatment of VTE and PE
- MI and unstable ACS
What are the contraindications to LMWH?
- Thrombocytopenia
- Anticoagulant use
What might patients with renal impairment require with LMWH?
Dose adjustment
Who should LMWH be used with caution in?
- Elderly patients
- Patients with hepatic impairment
- Low body weight
What should be done before starting treatment with LMWH?
- Measure FBC (platelets) and U&Es (potassium) before starting treatment
- Calculate creatinine clearance
Why should you calculate creatinine clearance before starting treatment with LMWH?
To ensure patients renal function is appropriate for dose they will be prescribed - if <30ml/min, should be prescribed half dose
What should be done if there is a change in the renal function of a patient on LMWH?
The dose should be reviewed
What should be done if thrombocytopenia occurs in a patient on LMWH?
Discontinue
What might LMWH interact with?
- NSAIDs
- Anticoagulants
- Antiplatelet drugs
What are the common side effects of LMWH?
- Haemorrhage
- Heparin-induced thrombocytopenia
What are the less common side effects of LMWH?
- Hypersensivity and injection site reactions
- Skin necrosis
- Hyperkalaemia
- Alopecia
What counselling is required with LMWH?
- Indication and duration
- Injection technique
- Excessive bleeding
