Indications: Prevent pulmonary embolism and deep vein thrombosis after hip or knee replacement surgery, abdominal surgery, patients with acute illness who are at increased risk because of decreased mobility. To prevent ischemic complications of unstable angina and non-Q-wave MI with oral aspirin theraphy. Drug Classification: Anticoagulants Mechanism of Action: A low moleculer weight heparin derivative that accelerates formation of anti-thrombin III-thrombin complex and deactivates thrombin, preventing conversion of fibrinogen to fibrin. Has higher anti-factor Xa to antifactor IIa activity ratio. Dosage: Initially at 40mg SC q8 for 10 days. Special Precaution: History of Heparin induced thrombocytopenia with or without thrombosis. Do not administer by IM route. Renal or hepatic insufficiency, History of hepatic ulcer, arterial hypertension, diabetic retinophaty, shortly after neuro or ophth surgery. Pregnancy Risk: B Adverse Reaction: Hemorrhage. Thrombocytopenia. Local reactions (Small local hematoma). Exceptional cases of skin necrosis. Rarely cutaneous or systemic allergic reaction. Increase liver enzymes. Contraindications: Conditions with high risk of uncontrolled hemorrhage including major bleeding disorders. Form: Ampules 30mg/0.3 ml, Syringes (prefilled) 30mg/0.3 ml, 40mg/0.4 ml, Vial 300mg/3ml Nursing Responsibilities: Monitor pregnant women using the drug Instruct patient and family to watch for signs of bleeding or abnormal bruising and to notify prescriber immediately if any occur. Tell patient to avoid OTC drugs containing aspirin or other salicylates unless ordered by physician.