New Nurse Tips: Lovenox vs. Heparin for DVT Prophylaxis
Nursing school is hard. Anyone who’s been through it knows. Perhaps the general public might not fully understand, but maybe they do, since nursing is once again the most trusted profession in the United States. (Yay team!)
The amount of knowledge thrown at nursing students is so voluminous that many new grads walk away a little shell shocked and wondering if they learned anything at all.
In fact, I don’t know a single nurse who didn’t feel a little overwhelmed and nervous when they started caring for patients all by their lonesome. In the short time I’ve been a BSN, RN, I’ve already learned stuff, or in many cases, re-learned stuff, that if you’d asked me on the first day of nursing school, I would have just given you a blank stare.
Yeah, pretty much exactly like that.
So! Anyway, long story short, as I embark on my second career as a nurse, I thought I might be able to pass along some of the practical knowledge I’ve gained to nursing students and new nurse grads, that may help them in their clinicals and/or roles as RNs.
Our first topic: Enoxaparin (Lovenox) vs. Heparin for DVT prophylaxis
I am an ICU nurse and pretty much every patient in our ICU will be on either Lovenox or Heparin for DVT prophylaxis. There are also SCD’s, but that’s a topic for another day; I’m trying to keep these posts relatively short.
If a patient has hepatic (liver) dysfunction, then most likely, they will not get Lovenox because it is metabolized in the liver. So, if the liver isn’t working, it may not clear the drug resulting in hepatotoxicity.
While Lovenox is metabolized in the liver, it’s primarily cleared through the kidneys. So, if the patient has kidney dysfunction, with no liver issues, they can still receive Lovenox, but at an adjusted dose.
TL;DR: Don’t give Lovenox to patients with liver problems.
Disclaimer: By no means is this a comprehensive analysis of enoxaparin and heparin for DVT prophylaxis. There are numerous other conditions in which cautious use of either would be warranted. The main point of these posts will be to hit the highlights. For example, in this case, if you get a patient on admission and you see they have a past medical history of liver dysfunction/failure, the first thing you should be thinking is, “be on the lookout for hepatotoxic medications.” You see what I’m getting at? I’m sure there are some nurses out there who have cared for patients who received Lovenox even though the patient has a liver dysfunction. That’s fine, but it’s the exception, not the rule.
Congratulations! If you made this far, send me a chat message and I’ll respond with a random fact about myself.