Please answer this Drug information questions. Provide evidence based responses and studies that support the responses.
What are some recommendations for enoxaparin dosing in obese patients? Are these supported by any guidelines or clinical trials?
I have provided some example as well as the rubric to be followed in files.
Use these for references:
SOURCES SEARCHED:
-Tertiary Resources: Micromedex; Clinical Pharmcology; Lexi-Comp; Facts & Comparisons; PDR; Package Insert; Ident-A-Drug; UpToDate; Clinical Guidelines/ www.guidelines.gov; Handbook on Injectable Drugs; Pharmacist Letter; Drugs in Pregnancy & Lactation; Natural Medicines Comprehensive Database; Handbook of Nonprescription Products; Other Textbook (specify) Website (e.g. CDC, FDA)
-Secondary Resources: PubMed; Google Scholar; OvidSP; Cochrane
-Jensen, MD, Ryan, DH, Apovian, CM. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society. Circulation. 2014;129(25, suppl 2):S102-S138. doi:10.1161/01.cir.0000437739.71477.ee
-Garcia, DA, Baglin, TP, Weitz, JI, Samama, MM. Parenteral anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2, suppl):e24S-e43S. doi:10.1378/chest.11-2291
-Kearon, C, Akl, EA, Comerota, AJ. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2, suppl):e419S-e496S. doi:10.1378/chest.11-2301
-https://journals.sagepub.com/doi/10.1177/1060028018821149
1. Curry, M. A., LaFollette, J. A., Alexander, B. R.,et al. (2019). Evaluation of Treatment-Dose Enoxaparin in Acutely Ill Morbidly Obese Patients at an Academic Medical Center: A Randomized Clinical Trial. Annals of Pharmacotherapy, 53(6), 567–573. https://doi.org/10.1177/1060028018821149
-Anon. Enoxaparin sodium. In: Adverse Reactions – Clinical Pharmacology (electronic version). Elsevier-Gold Standard, Tampa FL. www.clinicalpharmacology-ip.com. Copyright date: 2020
-Lovenox [package insert]. Bridgewater, NJ: Sanofi-Aventis LLC; 1993.
-Lim, W. Using low molecular weight heparin in special patient populations. J Thromb Thrombolysis. 2010;29:233-240. doi:10.1007/s11239-009-0418-z
-Thompson-Moore, NR, Wanat, MA, Putney, DR, Liebl, PH, Chandler, WL, Muntz, JE. Evaluation and pharmacokinetics of treatment dose enoxaparin in hospitalized patients with morbid obesity. Clin Appl Thromb Hemost. 2015;21:513-520. doi:10.1177/1076029614568713
-Lee, YR, Vega, JA, Duong, HN, Ballew, A. Monitoring enoxaparin with antifactor Xa levels in obese patients. Pharmacotherapy. 2015;35:1007-1015. doi:10.1002/phar.1658
-https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/Pharmacy-Education-Materials/Downloads/enox-dosingchart11-14.pdf
-https://www.lovenox.com/dosing-and-administration
