Low Molecular Weight Heparin (LMWH)

Question 1

What are some advantages to low molecular weight heparin compared to UFH?

Answer 1

-Good bioavailability
-Predictable dose response
-Fixed or weight-based dosing possible
-Monitoring not required
-Once or twice-daily dosing
-Improved subcutaneous absorption
-Reduced incidence of HIT, and possibly, bleeding (bleeding still most common SE)

Question 2

What dosing regimen of enoxaparin should be used for prophylaxis of surgery?

Answer 2

30 mg subQ Q12H

Question 3

What prophylactic dosing regimen of enoxaparin should be used for acutely ill patients in the hospital?

Answer 3

40 mg subQ daily

Question 4

What dosing regimens of enoxaparin should be used for treatment?

Answer 4

-1 mg/kg subQ Q12H
-1.5 mg/kg subQ daily

Question 5

What prophylactic dosing regimen of enoxaparin should be used for patients with renal dysfunction?

Answer 5

30 mg subQ daily

Question 6

What dosing regimen of enoxaparin should be used for treatment for patients with renal dysfunction?

Answer 6

1 mg/kg subQ daily

Question 7

When should you consider monitoring anti Xa levels?

Answer 7

-Consider for children, severe kidney failure, obesity, long courses, pregnancy
-Routine monitoring is not recommended

Question 8

Examples of low molecular weight heparins

Answer 8

-Enoxaparin (Lovenox)
-Dalteparin (Fragmin) (Not used very often anymore so do not worry about this one)