 Repeat prothrombin time and INR in a.m.  Once she has come down to a more therapeutic range, I would initiate low-molecular weight heparin in the form of Fragmin one time a day or Lovenox on a b.i.d. 
Repeat prothrombin time and INR in a.m. Once she has come down to a more therapeutic range , I would initiate low - molecular weight heparin in the form of Fragmin one time a day or Lovenox on a b.i.d .