FRAGMIN 1. Name & class of drug – generic and trade name.

GENERIC NAME: Dalteparin Sodium BRAND NAME: Fragmin CLASSIFICATION: blood formers, coagulators, and anticoagulants 2. Dose range and routes for adult & geriatric client. PREPARATIONS: SC – (2500, 5000, 10000) IU/0.2 ml injections DOSING: DVT Prophylaxis – ABD surgery – SC 2500 IU (16 mg) qd starting 1 – 2 hr prior to surgery and continuing for 5 – 10 d post op DVT Prophylaxis – Total hip Arthroplasty – SC 2500 – 5000 IU qd starting 1 – 2 hr prior to surgery and continuing for 5 – 14 d post op Acute thromboembolism – SC 5000 IU bid for 3 – 6 months Unstable angina/ non Q-wave MI – 120 IU/kg (max 10,000 IU) q12h 3. Purpose prescribed. Underline reason your client is prescribed drug. THERAPEUTIC EFFECTS: anticoagulants, low molecular weight heparin USES: prevention and Tx of DVT following hip or knee replacement or ABD surgery, instable angina, acute coronary symptoms 4. Major side effects & drug interactions. DRUG INTERACTIONS: Aspiring, NSAIDs, Warfarin can increase risk of hemorrhage SIDE EFFECTS: pain and inflammation at injection site, dizziness, headache, insomnia, N/V, thrombocytopenia

5. Nursing Implications & teaching. IMPLICATIONS: • Alternate injection sites • CBC with platelet count, urinalysis, and stool for occult blood should be tested throughout therapy • Carefully monitor for and immediately report S&S of excessive antigoagulation or hemorrhage. • Pt should be sitting or lying supine for injection. • Inject deep SC with entire length of needle inserted into skin fold • Hold skin folds gently during injection and do not rub site after injection TEACHING: • Tell all your medical doctors and dentists that you are using this medicine . • Check with your doctor immediately if you notice any of the following side effects: o Bruising or bleeding, especially bleeding that is hard to stop. (Bleeding inside the body sometimes appears as bloody or black, tarry stools or causes faintness.) o Back pain; burning, pricking, tickling, or tingling sensation; leg weakness; numbness; paralysis; or problems with bowel or bladder function.