Clinical Medications Worksheets Generic Name Trade Name Classification Dose Route Time/frequency enoxaparin Lovenox Anticoagulants, Anticoagulants, antithrombotics 40 mg SQ qid Peak Onset Duration Normal dosage range Unknown unknown 12 hrs 40mg SQ daily Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions Prevention of thrombus thrombus formation. Systemic anticoagulation anticoagulation N/A for prevention of ischemic or thrombotic events (e.g., MI, stroke) Mechanism of action and indications Nursing Implications (what to focus on) (Why med ordered) Contraindications/warnings/interactions Systemic anticoagulation Hypersensitivity Hypersensitivity,, uncontrolled bleeding, GI Potentiates the inhibitory effect of antithrombin on factor Xa bleeding/ulceration/pathology bleeding/ulceration/pathology.. Geriatric patients (enoxaparin and thrombin elimination prolonged). prolonged). Retinopathy (hypertensive (hypertensive or diabetic). Untreated hypertension. hypertension. History of congenital congenital or acquired bleeding disorder. disorder. Recent history history of ulcer ulcer disease. Hemorrhagic stroke. Common side effects Dizziness, headache, insomnia, constipation, N/V, urinary retention, bleeding, anemia, thrombocytopenia thrombocytopenia Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine medicines (ask patient specifically) Reversible increase in liver enzymes, monitor CBC, platelet count and Plavix: Drugs that can affect hemostasis such as dextran, , monitor closely if thrombocytopenia thrombocytopenia occurs, if decrease in hematocrit platelet inhibitors, thrombin inhibitors, thrombolytic agents, or occurs, assess for hemorrhage other anticoagulants may potentiate the risk of bleeding Be sure to teach the patient the following about this medication complications associated associated with the use of a low molecular Advise patient to report any symptoms of unusual bleeding or bruising, weight heparin (LMWH), heparinoid, or fondaparinux. In dizziness, itching, rash, fever, swelling, or difficulty breathing to health patients receiving neuraxial anesthesia or spinal puncture, the care professional immediately immediatel y. Instruct patient not to take aspirin, risk of developing an epidural or spinal hematoma during naproxen, or ibuprofen without consulting health care professional LMWH, heparinoid, or fondaparinux therapy may also be while on enoxaparin therapy. increased by the concomitant use of other drugs that affect coagulation. The development of epidural and spinal hematoma can lead to long-term or permanent paralysis. ASA: In patients receiving neuraxial anesthesia or spinal puncture, the risk of developing an epidural or spinal hematoma during low molecular weight heparin (LMWH) or heparinoid therapy may be increased by the concomitant use of other drugs that affect coagulation, including nonsteroidal antiinflammatory drugs (NSAIDs). The development of epidural and spinal hematoma can lead to long-term or permanent paralysis. Nursing Process- Assessment (Pre-administration assessment) Assess for signs and symptoms of bleeding and hemorrhage (bleeding gums; nosebleed; unusual bruising; black, tarry stools; hematuria; fall in hematocrit or blood pressure; guaiac-positive guaiac-positive stools), assess for signs and symptoms of of thrombosis, observe injection sites for hematomas.
Assessment Why would you hold or not give this med? Hypersensitivity Hypersensitivity (chills, fever, urticaria). Assess for signs of bleeding and hemorrhage (bleeding gums; nosebleed; unusual bruising; black, tarry stools; hematuria; fall in hematocrit or blood pressure; guaiac-positive stools); bleeding from surgical site. Notify physician or other health care professional if these occur.
Evaluation Check after giving Unusual bleeding or hemorrhage. Prevent DVT/clot formation. Observe injection sites for hematomas, ecchymosis, or inflammation.
