Question

Question # 1: When transitioning a patient on anticoagulation therapy taking heparin to enoxaparin (LovenoxĐ), you recognize what important difference between these two medications? a. Enoxaparin imposes NO dietary restrictions, but heparin requires limiting intake of vitamin K b. Enoxaparin remains active longer than heparin, delay is needed before starting heparin after enoxaparin c. OÉnoxaparin may be administered intravenously in nonemergency situations, but at amuch slower rate than heparin.

Answer 1

1. Both enoxaparin and heparin are anticoagulants ,but enoxaparin is a low molecular weight heparin . They are used to keep the blood thin and avoid clotting to prevent embolism ,thrombosis ,etc in patients who have a history of stroke , myocardial infarction,deep vein thrombosis etc. While Vitamin k promotes blood clotting . In the liver ,body uses vitamin k to produce substances needed for blood clotting. It interacts with anticoagulants such as heparin ,warfarin ,decreasing their effectiveness of preventing blood clotting, hence we have to maintain a strict consistent amount of vitamin k to ensure blood stays in right consistency to prevent clotting .Enoxaparin does not interact with vitamin k,so it is not necessary to avoid foods rich in vitamin k with enoxaparin.

2. Enoxaparin is designed in such a way that it lasts longer in the body ,so when there is a switching of enoxaprin with heparin ,there must be a delay before starting heparin because if you start heparin then it will lead to over dosage and may lead to side effects like excessive bleeding , thrombocytopenia because enoxaparin lasts longer in the blood .

3.Enoxaparin is a low molecular weight heparin. It produces a more predictable anticoagulant response so frequent monitoring is not needed to adjust the dose . It is also designed in such a way that it lasts longer in the body so it does not needs to be injected intravenous instead it's given subcutaneous . Because of its predictable efficacy and lower side effects patients can themselves inject it at home ,but when it's given intravenously it is given at slower rate because some times sudden gush of medicine .Might lead to allergic reactions and other side effects so, it has to be initially given at a slow rate and look for any side effects then if there is no side effects then increase the rate slowly but it's less than heparin flow rate because it is a derivative of heparin .