UAB Synopsis, Vol. 24, No. 10, March 10, 2005
Reminders For Proper Therapy
Agents commonly used in the prophylaxis for deep venous thrombosis (DVT) include unfractionated heparin and low-molecular weight heparins (the UAB Formulary agent is enoxaparin sodium). In this setting, unfractionated heparin is typically dosed 5,000 units subcutaneously (SC) every 8 hours, while enoxaparin is usually dosed 30 mg SC every 12 hours or alternatively 40 mg SC every 24 hours. Dosage adjustments and/or increased monitoring of blood parameters may be necessary in patients with moderate-to-severe renal impairment (ie, creatinine clearance less than 30 mL/min).
Additionally, the Pharmacy Department reminds prescribers to verify the patient's medication profile prior to initiating therapy with either unfractionated heparin or enoxaparin to avoid potential harmful duplicate therapy. Use of either agent in patients with active major bleeding, in patients with thrombocytopenia associated with a positive in vitro test for antiplatelet antibody in the presence of enoxaparin/heparin, in patients with hypersensitivity to enoxaparin/heparin, or in patients with an indwelling epidural catheter or spinal drains or repeated spinal procedures (ie, more than two attempts to access) should be avoided. For further information, contact the Drug Information Service at 934-2162.