Drug name: Lovenox is the trade name of Enoxaparin sodium. It is low molecular weight equivalent of heparin. Other trade names of this compound are Xaparin and Clexane.
Dose and route of administration: Patients at risk of thromboembolic complications, from abdominal surgery, are given 40mg Lovenox per day. The drug is administered 2 hours prior to surgery, via subcutaneous route. For patients undergoing knee or hip displacement, Lovenox is given 12 hours prior to surgery, at the rate of 30mg, for thromboprophylaxis. The dose is continued for 7 to 10 days. For outpatients with deep vein emboli, Lovenox is dosed at the rate of 1mg/kg body weight, for every 12 hours via subcutaneous route. (Drugs.com,2015)
Drug classification: Lovenox is classified under the class anticoagulants, hematologic and cardiovascular drugs.
Mechanism of Action: Lovenox is a low molecular weight heparin that inhibits blood clotting factor Xa and Factor IIa, both of which are essential for the formation of blood clot. The inhibitory effect of the drugs is due to its ability to activate antithrombin III, which inhibits Xa and IIa. Lovenox have shorter duration of action than heparin, and thus, does not need monitoring like heparin dosage. (Clevelandclinicmeded.com, 2015)
Major side effect and contradiction: Side effect and rare. Some rare side effect noticed in patients are anemia, hemorrhage, decreased platelet count, fever and edema. Though there are no strict contradictions, it is better to avoid the drug in pregnancy, breast feeding, pediatrics and geriatrics, as studies in these population are limited. It can be prescribed by weighing the benefits against its harm. Lovenox is contraindicated in spinal injury, spinal surgery, kidney diseases, liver diseases, eye problem associated with diabetes, stomach ulcers and in low platelet count.
Drug usage in diagnosis: Lovenox is used in conditions like deep vein thrombosis, acute coronary syndrome, prophylaxis of abdominal surgery, hip replacement, knee replacement and heart attacks. (Drugs.com,2015)
Excretion of drug: Lovenox is metabolize in the liver into inactive products. Both active and inactive byproducts are excreted through the kidney. Half-life of a single subcutaneous dose is 4.5 hours and on repeated dosing, it was found to 7.0 hrs. (Clevelandclinicmeded.com, 2015)
Lab monitoring of the drug: Effect of Lovemox, was found to be consistent from patients to patient and is safe at the correct dose. It is not monitored in the laboratory usually. However using this drug in patients with liver dysfunction or renal diseases may require monitoring. The anticoagulant activity of the drug, can be tested by anti-Xa inhibition assay. Blood for this assay is draw after 4 hours of Lovemox administration. The drug peak concentration is seen during this time. (Drugs.com,2015)
Nurses advice to patient on Lovemox use: Very often patient don’t appreciate the need for continuing Lovenox once the symptoms subside. Particularly in patients with pulmonary emboli. In all cases of treatment, the nurses must advice the patients to complete the whole course of Lovenox shots, even after the symptoms subside. Abruptly discontinuing the drug usually results in recurrence of thromboembolism.
Antidote: Protamine is used as an antidote for Lovenox. It is administered at the rate of 1 mg for 1mg Lovenox, by slow intravenous infusion.
References
Clevelandclinicmeded.com,. (2015). Retrieved 23 July 2015, from http://www.clevelandclinicmeded .com/ medicalpubs/pharmacy/janfeb2003/enoxaparin.htm
Drugs.com,.(2015). Lovenox Dosage –Drugs.com. Retrieved 23 July 2015, from http://www.drugs.com/dosage/lovenox.html
