Enoxaparin

Question 1

Enoxaparin Mechanism of Action

Answer 1

• Enoxaparin is a low molecular weight heparin (LMWH) anticoagulant.
• Enoxaparin potentiates the activity of antithrombin lll (a naturally occurring
anticoagulant) causing inhibition of multiple coagulation factors, particularly
factor Xa.

Question 2

Enoxaparin Indications

Answer 2

STEMI in conjunction with fibrinolytic therapy.

Question 3

Enoxaparin Contraindications

Answer 3

Known severe allergy

Question 4

Enoxaparin Cautions

Answer 4

Clinically significant bleeding. Enoxaparin will increase bleeding.
At risk of bleeding. If there are any cautions or contraindications present within the fibrinolytic/PCI checklist, personnel must seek clinical advice or discuss with the STEMI coordinator prior to administration.
Pregnancy.

Question 5

Enoxaparin Use in pregnancy/while breastfeeding

Answer 5

• Safety has not been demonstrated. The likelihood of STEMI occurring in a woman who is pregnant is so low that personnel must seek clinical advice or
discuss with the STEMI coordinator prior to administration.
• May be administered if the patient is breastfeeding. Advise the patient to stop breastfeeding and seek further advice from their lead maternity carer or GP.

Question 6

Enoxaparin Dose

Answer 6

Based on age and estimated weight

         Less than 75yo | Greater than 75 yo <60 kg:     60 mg (0.6 ml) | 45 mg (0.45 ml 60-69 kg: 70 mg (0.7 ml) | 50 mg 0.5 ml 70-79 kg: 80 mg (0.8 ml) | 60 mg 0.6 ml 80-89 kg: 90 mg (0.9 ml) | 70 mg 0.7 ml ≥ 90 kg:   100 mg (1 ml)    | 75 mg 0.75 ml

Question 7

Enoxaparin Preparation

Answer 7

• Pre-filled syringe containing 100 mg in 1 ml.

Question 8

Enoxaparin Administration

Answer 8

Subcut into abdo wall
No need to sterilise skin unless soiled
Discard unwanted drug prior to administration
If an error is made in discarding unwanted drug volume and the dose remaining in the syringe is less than planned, administer the remaining dose.

Question 9

Enoxaparin Common adverse effects

Answer 9

• Increased bleeding.

Question 10

Enoxaparin Onset of effect

Answer 10

10-30 minutes

Question 11

Enoxaparin Duration of action

Answer 11

12-24 Hours

Question 12

Enoxaparin Pharmacokinetics

Answer 12

• Enoxaparin is predominately excreted in urine.
• Clearance is prolonged if the patient has significant renal impairment, but this
does not alter the initial (loading) dose.

Question 13

Enoxaparin Common interactions

Answer 13

• The risk of bleeding will be increased if the patient is taking an anticoagulant.