Choose an injection site place on your body to give the injection where you can pinch a 1 to 2-inch 2. If your healthcare provider tells you to use a certain injection site, follow their instructions. Give the injection in a different area each time. Injecting in the same spot each time will make scar tissue form. It will also make it hard to put the needle into your skin.
Read the resource How to Store and Dispose of Your Home Medical Sharps for information about choosing a sharps container and disposing of your used syringes and other home medical sharps. Your feedback will help us improve the information we provide to patients and caregivers.
We read every comment, but we're not able to respond. If you have questions about your care, contact your healthcare provider. For more resources, visit www. Check off one of the boxes below to help you remember how to store your syringes.
Archives of Internal Medicine ; , Central nerve block and thromboprophylaxis-is there a problem? British Journal of Anaesthesia 82 2 ; Epidural haematoma after rmoval of an epidural catheter in a patient receiving high-Dose enoxaparin. Yin, B. British Journal of Anaesthesis 82 2 British Journal of Haematology. Thrombosis and Haemostsis. Recommendations for the development of a dedicated paediatric anticoagulation service.
Journal of Thrombosis and Haemostasis. In press. Anticoagulation in Children. Newall F, Monagle P. Thrombosis Research. Recommendations for developing uniform laboratory monitoring of heparinoid anticoagulants in children. The Royal Children's Hospital Melbourne. In this section About us Haemophilia treatment centre Anticoagulaton service Referral Intranet resources - haematology Staff Contact us. Indications Low Molecular Weight Heparins are used for the prophylaxis or treatment of deep vein thrombosis.
Recommended LMWH dosing for infants and children 2. Administration of mg doses of LMWH The 20mg and 40mg pre-filled syringes are ready for immediate use and are not graduated. Preparation and administration of doses from graduated syringes 60mg, 80mg, mg, mg, mg Patients to whom Clexane in graduated syringes is dispensed must be taught how to expel the unnecessary volume of drug from the syringe. Timing of commencement of therapy especially post-procedural should be individualised.
Monitoring of LMWH therapy in infants and children Recent evidence demonstrates infants and children achieve highly variable dose-response to clexane. The therapeutic range for LMWH administered to prevent a thrombosis is 0.
Nomogram for adjustment of LMWH therapy Table 2 outlines dose adjustments required for a given anti-Xa result in patients requiring an anti-Xa assay between 0. Hold Next Dose? Dose Change? Dose changes should be increased or decreased to the nearest whole number as per the LMWH dosing guidelines above Table 2. Hypersensitivity to heparin, pork products, or benzyl alcohol in multidose vials.
Prosthetic heart valves: not recommended esp. Neuraxial anesthesia and post-op indwelling epidural catheter or spinal puncture risk of epidural or spinal hematoma: see full labeling.
History of spinal surgery or deformity. Bacterial endocarditis. Congenital or acquired bleeding disorders. Active ulceration and angiodysplastic GI disease. Hemorrhagic stroke. Recent brain, spinal or eye surgery.
In pivotal trial, first subcutaneous dose given within 15 minutes of intravenous bolus 1 Duration of therapy Lovenox treatment duration in the pivotal clinical trial was 8 days or until hospital discharge, whichever came first.
An optimal duration of treatment is not known, but it is likely to be longer than 8 days. In pivotal trial, first subcutaneous dose given within 15 minutes of intravenous bolus 1.
Lovenox treatment duration in the pivotal clinical trial was 8 days or until hospital discharge, whichever came first. No initial intravenous bolus; 0. Patients transitioned to PCI 1. No additional dosing needed Administer Lovenox 0.
Dose modifications. See information about the use of Lovenox across different special population types. Patient characteristics 1. The risk of these events is higher with the use of postoperative indwelling epidural catheters, with the concomitant use of additional drugs affecting hemostasis such as NSAIDs, with traumatic or repeated epidural or spinal puncture, or in patients with a history of spinal surgery or spinal deformity [see Boxed Warning, Adverse Reactions 6.
Therefore, frequent monitoring of peak and trough anti-Factor Xa levels, and adjusting of dosage may be needed [see Use in Specific Populations 8. Women with mechanical prosthetic heart valves may be at higher risk for thromboembolism during pregnancy and, when pregnant, have a higher rate of fetal loss from stillbirth, spontaneous abortion, and premature delivery.
Frequent monitoring of anti-Factor Xa levels and adjusting of dosage may be needed see Boxed Warning in full Prescribing Information. Nursing mothers It is not known whether this drug is excreted in human milk Because many drugs are excreted in human milk, and because of the potential for serious adverse reactions in nursing infants from Lovenox, a decision should be made whether to discontinue nursing or discontinue Lovenox, taking into account the importance of Lovenox to the mother and the known benefits of nursing.
Pediatric use Lovenox is not approved for use in neonates or infants. Additional adverse reactions included gradual neurological deterioration, seizures, intracranial hemorrhage, hematologic abnormalities, skin breakdown, hepatic and renal failure, hypotension, bradycardia, and cardiovascular collapse. Preterm, low-birth weight infants may be more likely to develop these reactions because they may be less able to metabolize benzyl alcohol.
The minimum amount of benzyl alcohol at which serious adverse reactions may occur is not known. Geriatric use—DVT in hip or knee replacement and abdominal surgery; treatment of DVT; prevention of ischemic complications of UA and non-Q-wave MI More than 2, patients, 65 years and older, have received Lovenox in pivotal clinical trials.
The incidence of bleeding complications was similar between geriatric patients as compared to younger patients when Lovenox was administered at doses of 1. The risk of Lovenox-associated bleeding increased with age. Serious adverse events increased with age for patients receiving Lovenox. Other clinical experience including postmarketing surveillance and literature reports has not revealed additional differences in the safety of Lovenox between geriatric and younger patients.
Careful attention to dosing intervals and concomitant medications especially antiplatelet medications is advised. Lovenox should be used with care in geriatric patients who may show delayed elimination of enoxaparin. Patients with mechanical prosthetic heart valves Use of Lovenox in patients with mechanical prosthetic heart valves has not been adequately studied.
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