Prescribing Safety Assessment (PSA) Practice Exam

When is prophylactic Enoxaparin contraindicated?

1. During pregnancy

2. Post-Ischaemic stroke

3. For patients with renal failure

4. Prior to major surgeries

The correct answer is: Post-Ischaemic stroke

Prophylactic use of Enoxaparin is relevant in various clinical situations, particularly to prevent thromboembolic events. However, it is crucial to note specific contraindications. In the context of this question, prophylactic Enoxaparin is not contraindicated post-ischaemic stroke. Instead, it may be beneficial in these patients to reduce the risk of venous thromboembolism, as immobility often accompanies this condition. During pregnancy, the use of Enoxaparin can often be considered safe and is regularly used under medical supervision to manage clotting risks. In patients with renal failure, cautious use is warranted, but it isn't outright contraindicated; the dosage may need to be adjusted based on kidney function. Prior to major surgeries, Enoxaparin use can increase the risk of bleeding, especially in procedures with a high risk of hemorrhage, which is a critical factor leading to careful consideration around its administration. Thus, the contraindication for prophylactic Enoxaparin is not seen post-ischaemic stroke, as the benefits may outweigh the risks in managing thromboembolic complications following such events, particularly in appropriately monitored scenarios.