NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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For the treatment of UA/NSTEMI with Low Molecular Weight Heparin, what is the dosage of Enoxaparin if CrCl <30?

1.5 mg/kg SC daily
30 mg SC QD
1 mg/kg SC daily
120 units/kg Q12H

The correct answer is: 1 mg/kg SC daily

For the treatment of UA/NSTEMI with Low Molecular Weight Heparin (LMWH) such as Enoxaparin in patients with a creatinine clearance (CrCl) less than 30 mL/min, the dosage is usually reduced to prevent accumulation of the medication in the body. The correct dosage of Enoxaparin for patients with CrCl less than 30 mL/min is 1 mg/kg subcutaneously daily. This adjusted dose helps reduce the risk of bleeding due to impaired renal clearance of the medication in patients with decreased kidney function. Options A, B, and D are incorrect: A. 1.5 mg/kg SC daily: This dosage is generally used for prophylaxis of deep vein thrombosis (DVT) in patients undergoing abdominal surgery, major orthopedic surgery, or in the treatment of acute ST-segment elevation myocardial infarction (STEMI). B. 30 mg SC QD: This dose is not the standard dosage for Enoxaparin, especially in patients with reduced CrCl. D. 120 units/kg Q12H: This dose is more in line with unfractionated heparin dosing rather than Enoxaparin dosing.