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Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
Low-molecular-weight heparin overdose: management by observation
Andrew A Monte1, Michael Bodmer, Tammi H Schaeffer
1Rocky Mountain Poison and Drug Center, University of Colorado Denver, USA. Andrew.Monte@rmpdc.org
The Annals of Pharmacotherapy
|October 7, 2010
Summary
Observation without intervention appears appropriate for low-molecular-weight heparin (LMWH) overdose cases lacking significant bleeding. Further monitoring may be needed for patients with kidney issues.
Area of Science:
- Pharmacology
- Clinical Medicine
- Toxicology
Background:
- Low-molecular-weight heparin (LMWH) is a widely used anticoagulant.
- Overdose cases require careful management to prevent complications.
- Limited data exists on the management of LMWH overdose.
Observation:
- Three episodes of intentional LMWH overdose (dalteparin and enoxaparin) were observed in two patients.
- Patients presented with elevated anti-Xa activity levels post-overdose.
- No bleeding complications or interventions were required in these cases.
Findings:
- Observation without intervention was successful in managing LMWH overdose when no significant bleeding occurred.
- Protamine and recombinant factor VIIa showed limited or in vitro efficacy for LMWH reversal in literature review.
- Renal failure may necessitate prolonged monitoring in LMWH overdose patients.
Implications:
- Current evidence suggests observation is a safe approach for uncomplicated LMWH overdose.
- More research is needed to establish clear treatment guidelines for bleeding complications following LMWH overdose.
- This case series contributes to understanding the clinical course and management of LMWH overdose.
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