Deep Venous Thrombosis (DVT) Prophylaxis (see Deep Venous Thrombosis, [[Deep Venous Thrombosis]])
Other Indications for Anticoagulation
xxxx
Pharmacology
Low Molecular Weight Heparin
Administration
SQ (DVT Prophylaxis): 40 mg qday or xxx
SQ (Full Anticoagulation): xxx
Dose Adjustment
Hepatic: xxx
Renal: xxx
Effect on Anticoagulation Tests
Prothrombin Time (PT)/International Normalized Ratio (INR) (see Prothrombin Time, [[Prothrombin Time]]): no effect
Enoxaparin is an indirect thrombin inhibitor and should theoretically prolong the INR: however, most INR assay reagents contain heparin-binders which block the effect of heparin (or similar agents) at concentrations <1 unit/mL -> therefore, at heparin concentration of >1 unit/mL, the INR may be prolonged
Partial Thromboplastin Time (PTT) (see Partial Thromboplastin Time, [[Partial Thromboplastin Time]]): no effect-prolonged
Anti-Factor Xa (see Anti-Factor Xa, [[Anti-Factor Xa]]): prolonged
Management of Enoxaparin Therapy Prior to Surgery/Procedure
Recommendations (Chest Antithrombotic Therapy and Prevention of Thrombosis 2012 Guidelines) [MEDLINE]
Administer Last Dose of Enoxaparin 24 hrs Prior to Surgery/Procedure (Grade 2C Recommendation)
Post-Operative Resumption of Enoxaparin Following Surgery/Procedure with High Bleeding Risk
Recommendations (Chest Antithrombotic Therapy and Prevention of Thrombosis 2012 Guidelines) [MEDLINE]
Resume Enoxaparin 48-72 hrs Following Surgery/Procedure (Grade 2C Recommendation)
Subdural Hematoma (SDH) (see Subdural Hematoma, [[Subdural Hematoma]])
Other Adverse Effects
xxx
References
Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):7S-47S. doi: 10.1378/chest.1412S3 [MEDLINE]