Cheat sheet

Quick reference

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NurseSavvy Cheat SheetDrug Class

Low-Molecular-Weight Heparin / Enoxaparin

LMWHs are short heparin fragments. They bind antithrombin III but are too short to bridge to thrombin, so they inactivate factor Xa almost exclusively — which is why the aPTT barely moves and is not used to monitor them. Subcutaneous absorption is predictable, so LMWH is dosed by weight or fixed amount with no routine lab monitoring.

UFH (heparin)LMWH (enoxaparin)
InactivatesThrombin (IIa) AND factor XaMostly factor Xa
RouteIV infusion or subcutaneousSubcutaneous only
MonitoringaPTT 1.5–2.5× controlNone routine; anti-Xa if needed
Half-life~60–90 min IV~4–7 hours
ReversalProtamine — completeProtamine — partial (~60%)
HIT riskHigherLower, but not zero

UFH (heparin)

Inactivates
Thrombin (IIa) AND factor Xa
Route
IV infusion or subcutaneous
Monitoring
aPTT 1.5–2.5× control
Half-life
~60–90 min IV
Reversal
Protamine — complete
HIT risk
Higher

LMWH (enoxaparin)

Inactivates
Mostly factor Xa
Route
Subcutaneous only
Monitoring
None routine; anti-Xa if needed
Half-life
~4–7 hours
Reversal
Protamine — partial (~60%)
HIT risk
Lower, but not zero
enoxaparinPrototype
Lovenox; 40 mg SC daily prophylaxis, 1 mg/kg q12h treatment
dalteparin
Fragmin; same class, weight-based
DVT prophylaxis after orthopedic surgery
hip and knee arthroplasty
DVT and pulmonary embolism treatment
acute coronary syndrome
bridging to warfarin
covers the delay before the INR rises
anticoagulation in pregnancy
does not cross the placenta; warfarin is teratogenic
injection-site bruising
injection-site pain
minor bleeding
gums, easy bruising

Contraindications

active major bleeding
history of heparin-induced thrombocytopenia
antibodies cross-react with LMWH
pork product hypersensitivity
heparins are porcine-derived

Interactions

antiplatelet agents
aspirin, clopidogrel — additive bleeding
NSAIDs
additive bleeding risk
thrombolytics
additive bleeding risk
do NOT expel the air bubble Hallmark
it clears the last of the dose into the tissue
inject into the abdomen
at least 2 inches from the umbilicus, alternating sides
insert at 90° into a pinched skinfold
do not aspirate or massage the site
both worsen bruising and hematoma
check baseline and serial platelet countswatch for ≥50% drop
aPTT does not track LMWH
a normal aPTT is expected and reassures nobody
protamine reverses LMWH only partially~60% of anti-Xa activity

Monitor

assess renal function before dosingCrCl < 30 → reduce dose
draw anti-Xa only when monitoring is needed
renal impairment, pregnancy, obesity, very low weight
keep the air bubble in the syringe
rotate injection sites side to side
report new back pain or leg weakness
possible spinal hematoma — emergency
report black or tarry stools
sign of GI bleeding
report pink or red urine
use a soft toothbrush and electric razor
avoid aspirin and NSAIDs unless prescribed
do not stop the drug before procedures
ask the prescriber first
Report Nowescalate immediately

The boxed warning is about neuraxial procedures, not bleeding in general — an epidural or spinal puncture plus LMWH demands a neurologic assessment, not just a look at the injection site.

spinal or epidural hematoma HallmarkBlack Box
FDA boxed warning — new back pain, leg numbness or weakness, bowel or bladder dysfunction; can cause permanent paralysis
major hemorrhage
GI bleed, intracranial bleed, hematuria, falling H&H
heparin-induced thrombocytopenia≥50% platelet drop
less common than with UFH but still occurs — paradoxical clotting, not bleeding

Clinical Pearl

Enoxaparin is heparin with the guesswork removed: fixed dose, no aPTT, given at home. Two things still bite — leave the air bubble IN the syringe, and treat new back pain or leg weakness after an epidural as a spinal hematoma until proven otherwise.

NurseSavvy™·nursesavvy.com

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