Drug Guide

Generic Name

Danaparoid Sodium

Brand Names Orgaran

Classification

Therapeutic: Anticoagulant

Pharmacological: Heparinoid

FDA Approved Indications

  • Prevention of deep vein thrombosis in postoperative patients with limited mobility
  • Treatment of deep vein thrombosis and pulmonary embolism in patients with heparin-induced thrombocytopenia (HIT)

Mechanism of Action

Danaparoid inhibits factor Xa and to a lesser extent factor IIa (thrombin), reducing clot formation by enhancing antithrombin III activity.

Dosage and Administration

Adult: Typically 2500-5000 units subcutaneously once daily, adjusted based on patient response and weight.

Pediatric: Limited data; use cautiously and under specialist supervision.

Geriatric: Same as adults; caution due to potential renal impairment.

Renal Impairment: Adjust dose based on renal function; dose reduction may be necessary.

Hepatic Impairment: Use with caution; no specific dosage adjustment established.

Pharmacokinetics

Absorption: Poor oral absorption; administered parenterally.

Distribution: Widely distributed; minimal binding to plasma proteins.

Metabolism: Metabolized enzymatically in tissues; minimal hepatic metabolism.

Excretion: Renally excreted; accumulation can occur in renal impairment.

Half Life: Approximately 24 hours in healthy individuals.

Contraindications

  • Active major bleeding
  • History of hypersensitivity to danaparoid or other heparinoids

Precautions

  • Monitor for bleeding complications, especially in patients with bleeding disorders or on concomitant anticoagulants.
  • Use with caution in patients undergoing invasive procedures.
  • Increased risk of bleeding in elderly and in patients with renal impairment.

Adverse Reactions - Common

  • Bleeding, including minor and major hemorrhage (Common)
  • Local injection site reactions (pain, erythema) (Common)

Adverse Reactions - Serious

  • Heparin-induced thrombocytopenia (HIT) (Rare)
  • Anaphylactic reactions (Rare)

Drug-Drug Interactions

  • Other anticoagulants (e.g., heparin, warfarin, direct oral anticoagulants)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor coagulation parameters (aPTT, anti-Xa activity), platelet counts, and signs of bleeding.

Diagnoses:

  • Risk for bleeding
  • Impaired tissue perfusion related to bleeding

Implementation: Administer doses as prescribed, monitor for adverse effects, and educate patient on bleeding precautions.

Evaluation: Assess for signs of bleeding, coagulation status, and efficacy of anticoagulation therapy.

Patient/Family Teaching

  • Report unusual bleeding or bruising immediately.
  • Inform about the importance of regular blood tests.
  • Advise to avoid activities that increase bleeding risk.

Special Considerations

Black Box Warnings:

  • Potential for bleeding complications.
  • Use caution in patients with renal impairment.

Genetic Factors: None specified.

Lab Test Interference: May alter coagulation tests; interpret with caution.

Overdose Management

Signs/Symptoms: Excessive bleeding, hematomas, hypotension, shock.

Treatment: Discontinue drug immediately, apply pressure to bleeding sites, and provide supportive care. In severe cases, administer protamine sulfate if appropriate and available.

Storage and Handling

Storage: Store at room temperature, away from direct light.

Stability: Stable for the duration specified by the manufacturer; check the packaging for expiry date.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.