Lovenox administration

[GoanO]

0I have concerns regarding the drug Lovenox... You see most of our patients prefer that we administer it to them through their upper arms or thighs; and while we have learned that it is acceptable to do that since it is afterall a subcutaneous medication, we have also read that it is FDA approved that it should be done on the abdomen.

What are your thoughts about this? Would you say it is ok to administer it to the upper arms or thighs? Or should we stick to the abdomen instead?

It will be nice to hear from you as soon as possible and if you could, please provide me something tangible to support my claims.

[roser13, ASN, RN]

What are your thoughts about this? And have you been following your patients' wishes and using their preferred sites?

What are your "claims" that you're asking us to support with "something tangible"?

[NICUismylife, ADN, BSN, RN]

I ask my patients where they prefer it. It's usually a pretty even split between arms and abdomen. I've never once administered in the thigh.

[KatieMI, BSN, MSN, RN]

Funny thing is, Canadian edition od Davis drug book allows SQ administration of Lovenox anywhere.

Davis's Canadian Drug Guide for Nurses® - April Hazard Vallerand, Cynthia A Sanoski - Google Books

FDA requires extremely detailed protocols for those pharmacokinetic studies that it deems "reliable" and denies existence of anything and any results received otherwise. Therefore, as all results were achieved on studies where the drug was administered in just one place (abdomen, since fat is more biologically active there and so considered to give more steady adsorbtion), this injection site was officially "approved". It doesn't mean it is the only one "correct" way; after all, it is kinda unlikely that human physiology differs between populations of the US and Canada.

It is a particular feature of FDA, which only once in history brought up a positive result (the history of thalydomide, where request for additional study on pregnant animals saved America from having 30000 to 50000 babies permanently maimed), thus stalling American medical science development and leading to unnecessary suffering and despair of patients and their families ever since.

[roser13, ASN, RN]

Guessing that we're answering homework questions....

[KatieMI, BSN, MSN, RN]

I doubt it is a homework. It is a situation I encountered innumerable times, when mindless following policies and schmolisies made up by someone's private opinion leads, in the best case, to absolurely unnessesary battle between patient and provider, and, as the worst, to poor outcome.

[Meeshie]

after all, it is kinda unlikely that human physiology differs between populations of the US and Canada.

Are you sure? Canadians are so nice... I always rather thought they were aliens...

[TheCommuter, BSN, RN]

Moved to the Nursing & Patient Medications forum.

[Tenebrae, BSN, RN]

Obviously I would try to take into account the patients preference.

However when i was district nursing we had people who would be on it for

months and the prefered site of administration would be the abdomen as

there is more opportunities to rotate the sites and less risk of causing

skin irritation.