Lovenox dosing in obese patients
Common Questions and Answers about Lovenox dosing in obese patients
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I had an ablation last week and am doing well, but am very beat up (low energy, black and blue, sore throat from TEE and polka dot bruises from Lovenox). My question is how long a time period is it usual to be on Lovenox? My doctor has said a full month. From my research, other than pregnant women, for all other conditions it says 2 weeks or less. I can't take coumadin due to a severe reaction to it.
Of note is that in the BOC trial, SVR rates in patients managed by RBV dose reduction alone were comparable to those in patients managed with erythropoietin therapy.23 Similarly, in the TVR trials, dose reduction of RBV had no effect on SVR rates, and therefore dose reduction should be the initial response to management of anemia.
SBPH), a clinical-stage biopharmaceutical company developing novel therapeutics for the treatment of viral infections, inflammatory diseases and cancer, today announced that it has begun dosing the first cohort of patients in the ACHIEVE global Phase 2 clinical program evaluating SB 9200 in immuno-active, treatment-naïve HBV patients without cirrhosis.
What I did was stop the Coumadin 5 days before, and then 4 days before started Lovenox to bridge up until the surgery (Lovenox is a subcutaneous injection and is a Low Molecular Weight Heparin that will keep the blot thin enough to prevent clotting). The night of the day of the procedure I had, I restarted the Coumadin, and the following day after the surgery used Lovenox for 2 days giving the Coumadin time to begin building back up again.
7 compared with those with genotype 1, cirrhotic patients had an OR of 0.15 compared with noncirrhotic patients, and obese patients had an OR of 0.23 compared with normal and overweight patients. Hepatic steatosis was not an independent risk factor for response to antiviral treatment. In conclusion, obesity, only when defined as a BMI greater than 30 kg/m(2), is an independent (of genotype and cirrhosis) negative predictor of response to hepatitis C treatment.
Retrieved from http://www.ncbi.
Hello,
I have been reading a lot lately about the side effects of Seroquel. The one that concerns me the most is the diabetes. I am obese and diabetes runs in my family. I even have a brother that is insulin dependent. I am wondering if I should get off this drug? Does the diabetes continue even after the drug is discontinued? Is there another antipsychotic I could take that does not have this side effect?
Thank you so much for your time.
Blood oxygen levels are not a botheration at this time but you should concentrate on losing some weight. Weight reduction, if you are overweight or obese, is the optimal health strategy for patients who suffer from COPD. This can be done through a combination of diet, an increase in physical activity and sometimes medication. Weight reduction can help reduce dyspnea, increase exercise tolerance and improve your quality of life.
Some surgeons request that a patient not be on plavix or warfarin at the time of surgery in order to minimize the risk of bleeding. Traditionally, the effects of plavix on platelets is minimal after 5 days. Usually, blood clots normally about three days after taking warfarin. This is quite variable and can be confirmed by a blood test (either checking INR or prothrombin time), prior to surgery.
The other night I was given 50 mg Lopressor, plavix, and lovenox, as I thought and the hospital thought I was having a cardiac event. I already take 25 mg atenolol. I wasn't having event, but non-specific chest pain. That was Monday night. Now I wake up with my heart racing and blood pressure rising. I also wake up exhausted. I think this is from coming off of the Lopressor. I called my MD and they said just go back to regular dose of atenolol.
The reason that aspirin will not work to thin your blood is because of your factor 5 deficiency. How this deficiency works to decrease clotting time doesnt have anything to do with how aspirin works. Aspirin will help counter the effects of the birth control pill, though, so is not a bad idea. Lovenox is a good idea to counter the factor 5 deficiency. so in my opinion, you should continue with the baby aspirin and lovenox as ordered.
The safety and effectiveness of these dosing interval adjustment recommendations have not been clinically evaluated in patients with moderate or severe renal impairment, therefore
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clinical response to treatment and renal function should be closely monitored in these patients [See Warnings and Precautions (5.3)]. There are no data to recommend use of VIREAD tablets 150, 200 or 250 mg or VIREAD oral powder in patients with renal impairment.
That depends on your doctors comfort levels in prescribing , a patients ability to tolerate side effects, other medical conditions, effectiveness of using opiates, but typically- most physicians will not prescribe over 90 to 100 MME mg dosing per day-(Morphine equivalent dosing per day)- and typically only for patients who have been on opiates for some time. MME dosing combines both long acting and immediate release types of opiates to reach 90-100mg MME daily.
Preliminary pharmacokinetic analyses of pre-dose samples taken on day 8 of dosing in approximately 50 patients in this study indicate that trough concentrations in those patients receiving a twice-daily dosing schedule are similar to trough concentrations of a three times daily dosing schedule, and are also similar to trough concentrations observed in PROVE 1 and PROVE 2.
Obese patients usually are encouraged to lose weight before having surgery. Although weight loss alone is not likely to solve the problem, it can make complications during and after surgery less likely. Weight loss and nutritional counseling can help patients before and after surgery.
Psychological counseling: Mental health professionals may address issues such as depression, sexual dysfunction, and low self-esteem.
Even though it has not yet been approved, Dr Eliot Godofsky, infectious disease specialist, University Hepatitis Center, Bradenton, Florida, has already been using the BID regimen in patients where it was thought the Incivek TID regimen would not work. Patients have reported less diarrhea when on the BID regimen, he added, speculating it may be due to the requirement of taking Incivek with a fatty meal.
Lovenox safety in pregnancy is a question that is best answered by your obstetrician or by a high risk maternal fetal medicine subspecialist. I personally do not believe the low positive cardiolipin titers were related to infertility; the relationship is with recurrent pregnancy loss. I too respect your RE' reasoning for initiating lovenox, but would not have done so myself - a matter of opinion and my interpretation of the research and evidence available.
On the day before administration of the next dose, peginterferon--2b was undetectable in nine patients in group A (once weekly dosing). The same pattern was observed during the next 3 weeks of therapy. In group B (twice weekly dosing) peginterferon--2b was detectable at any given time point and higher than in group A (P between 0.01 and <0.0001). Viral load decreased in all patients within 2 days after the first dose of peginterferon--2b, but increased again on day 3.
In a Phase IIa combination trial in HCV patients, we reported data that showed that setrobuvir added to pegylated interferon and ribavirin accelerated the rate of viral clearance, with comparable response at setrobuvir doses of 200 mg bid and 400 mg bid. A single patient out of more than 60 exhibited viral breakthrough while receiving setrobuvir plus standard of care, corresponding to a low breakthrough rate of < 2%.
The authors also suggested that use of higher doses of pegylated interferon and ribavirin for extended periods might help overcome the lower response rates observed in obese patients. Weight-based dosing and longer treatment durations are currently the subject of considerable research, but the authors also suggested higher dosing based on levels of insulin resistance or amount of visceral fat, rather than body weight alone.
I was put on Lovenox and a baby aspirin 2 weeks prior to miscarrying. The Doctor seems to think that when we get pregnant again that I can get on Lovenox and baby aspirin when i'm 7 weeks pregnant and that the pregnancy will be a healthy succuessful one. I'm just wondering has anyone else had a successful pregnancy taking Lovenox? Just really nervous and have alot of questions now. Should I go ahead and take the baby aspirin now or wait? The Doctor says we can try again in October.
Likewise, ultrasound in obese patients is not nearly as accurate in diagnosing fatty liver as it is in normal weight individuals. Your liver enzymes are really not that far out of range that you should panic or anything like that but they do suggest some ongoing damage which should be diagnosed with as much certainty as possible.
You said you saw a "specialist' who told you because you're extremely obese you obviously have fatty liver. What type of specialist was this doctor?
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