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The generic name of the drug
Enoxaparin
Consumption in pregnancy:
B
Pharmacy Group - Therapy:
Low molecular weight heparin (LMWH) - Antitrombotic
Pharmaceutical forms:
Prefilled syringe
4000, 6000
Pharmacokinetics - Dynamics, Mechanism of Effect
The molecular weight of enoxaparin is approximately 4500 (2000-8000) daltons of low molecular weight heparins (LMWHs). This drug, by binding to antithrombin II and activating it, inhibits factor X and IIa. The main effect of these drugs on the inhibition of factor Xa is that it has been shown to be effective on factor IIa (thrombin) and clotting time (ie, timing of the tropical (TT) and aPTT) that enoxaparin increases the serum levels of fatty acids Non-sterile, without changing the concentration of cholesterol, triglycerides or phospholipids.
This drug is immediately and almost completely absorbed following SC injection and its bioavailability is 92%. The volume of distribution is 3 / 9-2 / 5 liters. Its metabolism is liver. 3-5 hours after SC injection reaches its maximum. Duration of the drug is max. 24 hours. Its disposal is more renal and decreases in renal failure.
Consumption by indication
DVT prophylaxis and pulmonary embolism
adults
Hip or Knee Replacement Surgery: 30 mg every 12 hours for SC injections. The first dose is given in the first 24 to 24 years after the operation. The duration of the medication is continued for 10-7 days. In the case of hip replacement, a 40-mg dose can be injected SC in the order of 15-9 hours prior to surgery, and this dose is administered once a day up to 3 weeks after the operation.
Abdominal Surgery: In adults who are prone to thromboembolism, 40 mg once daily for approximately 7-10 days (up to 12 days) after surgery, and a dose is also given 3 hours before SC surgery.
Treatment for DVT and pulmonary embolism
Adults: If an individual with a lung-free AVT and can be treated at home, an outpatient regimen or a dose of 1 mg / kg every 12 hours is recommended for SC, and if there is DVT and associated pulmonary embolism Or that the patient is not a suitable candidate for an outpatient treatment, he / she is admitted and given 1mg / kg every 12 hours SC or 1 / 5mg / kg once a day. In both cases, the first 2 days of treatment with enoxaparin usually begins with warfarin administration. Treatment with enoxaparin is continued for at least 4 days and until the anticoagulant effect of warfarin is increased to a therapeutic level, the course of treatment with enoxaparin is 7 days and sometimes lasts for up to 14 days.
Children and infants: Each dose of 1mg / kg is injected every 8 hours.
Unstable angina and MI without wave Q
Adults: To prevent thrombotic events caused by unstable angina or MI without Q wave, 1 x 10 mg / kg of enoxaparin is injected every 12 hours with oral aspirin (100-325 mg once daily) The duration of the treatment is at least 2 days and should be continued until the patient becomes clinically stable. The duration of treatment is usually 8-2 days. Note that the placement of venous veins in these patients will be associated with the risk of bleeding. In order to reduce the risk, it is recommended that after intravenous administration, at least 8-6 hours after intravenous injection of enoxaparin, it is recommended that the next dose of enoxaparin It should be done at least 8-6 hours after the intravenous route is removed.
Note: Note the following when taking this medicine:
1) Only SC injections. 2) Patients with normal preoperative coagulation parameters are not required to monitor the daily effects of enoxaparin. 3) The factors that cause DVT to occur and require prophylaxis include: 40 years of age, obesity, those undergoing surgery and requiring general anesthesia for more than 30 minutes, although there is another risk factor such as malignancy or a history of DVT or pulmonary embolism. 4) In order to inox enoxaparin, alternate use of the outer and outer anterior wall of the outer and posterior side of the right and left abdomen. 5) Inject SC, insert the entire length of the needle into the skin of the skin with your thumb and sign, and do not rub the injection area to reduce bruising. 6) Modify the dose for patients with severe kidney failure or those who weigh less than 45 kg. 7) Do not mix Enoxaparin with other injectable drugs or infusion solutions.
Contraindications and precautions
If there is excessive sensitivity to LMWHs, heparin or pigs are contraindicated.
In patients with major active hemorrhage, severe thrombocytopenia induced by heparin or enoxaparin over the past few months, severe and uncontrolled hypertension, confirmed or suspected cerebral hemorrhage and pregnancy-induced abortion should not be prescribed.
The use of this drug with anterior dorsal or spinal anesthesia may be accompanied by the formation of spinal adiposteror hematoma, leading to permanent or prolonged paralysis. The risk of developing a hematoma is particularly high in cases where the epidertal canister is left in place or used for other medications that impair homeostasis. In these cases, caution should be exercised when using enoxaparin after assessing the potential risks to the benefits of prescribing the medicine.
In all people who are prone to bleeding, such as those with hemorrhagic diseases, diabetic retinopathy, bacterial endocarditis, congenital or acquired coagulation disorders, active ulcer and angiocyclase in the GI, hemorrhagic stroke, shortly after surgery of the brain, spinal cord or eye Pericarditis or pericardial effusion should be prescribed with caution.
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