Enoxaparin Thromboprophylaxis Dosing and Anti-Factor Xa Levels in Low-Weight Patients.

INTRODUCTION: Enoxaparin is a widely used anticoagulant to prevent venous thromboembolism (VTE). A fixed dose is recommended for VTE prophylaxis. However, fixed prophylactic doses of enoxaparin in low-weight patients may be close to the weight-based dosing recommended for VTE treatment. OBJECTIVE: To evaluate peak anti-factor Xa (aFXa) levels in low-weight patients receiving enoxaparin for VTE prophylaxis. METHODS: Retrospective cohort of adult patients weighing < 55 kg who were hospitalized at Loma Linda University Medical Center between January 2008 and February 2017. All patients received enoxaparin for VTE prophylaxis with a peak aFXa level drawn. The primary endpoint was the proportion of patients achieving peak aFXa levels within the goal range of 0.2-0.5 unit/ml. RESULTS: Of 35 patients receiving enoxaparin for VTE prophylaxis with an appropriately timed peak aFXa level, 74% achieved goal peak aFXa levels and the median daily dose of enoxaparin was 30 mg. The mean weight was approximately 44 kg. No significant correlations between aFXa level and body mass index or body weight were found. CONCLUSION: A lower dose of enoxaparin may be reasonable in low-weight patients for VTE prophylaxis. There appears to be no safety concerns with reduced enoxaparin dosing in low-weight patients. More robust data are needed to confirm these findings.

Assessment of Burnout and Associated Risk Factors Among Pharmacy Practice Faculty in the United States.

Objectives. To measure the level of burnout among pharmacy practice faculty members at US colleges and schools of pharmacy and to identify factors associated with burnout. Methods. Using a cross-sectional, electronic, anonymous survey-design, we measured faculty burnout (n=2318) at US colleges and schools of pharmacy using the Maslach Burnout Inventory-Educators Survey (MBI-ES), which measures burnout dimensions: emotional exhaustion, depersonalization, and personal accomplishment. We assessed MBI-ES scores, demographics and possible predictors of burnout. Results. The response rate was 32.7% (n=758). Emotional exhaustion was identified in 41.3% and was higher in women, assistant professors, and those without a hobby. Participants without a mentor had higher scores of depersonalization. Those with children ages 1-12 years had higher emotional exhaustion and depersonalization compared to those with older children. Conclusion. Pharmacy practice faculty members at US colleges and schools of pharmacy are suffering from burnout, exhibited mainly through emotional exhaustion.