What are the most common uses for heparin therapy?
What are the Most Common Uses for Heparin Therapy? Heparin therapy is commonly used to help prevent blood clots. Heparin is an enzyme created in the body and used in medicine as an anticoagulant. Heparin therapy commonly is used to treat thrombosis, which occurs when there is a blood clot within a blood vessel and can be fatal if not treated.
What are the adverse effects of heparin?
Heparin use's typical adverse effects include bleeding, thrombocytopenia, injection site reactions, and other adverse effects only seen with chronic heparin administration. Bleeding is a major complication associated with heparin use. Patients should undergo monitoring for new bleeding that may present in the urine or stool.
Why is heparin usually administered before dialysis treatment?
It is customary at most centers to add heparin whenever fibrin or blood or both is seen in the drainage bag. Fibrin formation is occasionally observed during routine dialysis, but more commonly when the PD catheter is being inserted and at the onset of peritonitis.
How does heparin work to break up clots?
Treatment of Thrombosis
- Heparin. Heparin is a strong, fast-acting anticoagulant (blood thinner). ...
- Low Molecular Weight Heparins. Low molecular weight heparins (LMWH) are similar to heparin but much easier to use. ...
- Warfarin. Warfarin (Coumadin®) is an anticoagulant pill that is taken by mouth. ...
What is heparin used for?
Heparin injection is an anticoagulant. It is used to decrease the clotting ability of the blood and help prevent harmful clots from forming in blood vessels. This medicine is sometimes called a blood thinner, although it does not actually thin the blood.
Why would a patient be given heparin?
Heparin is used to prevent blood clots from forming in people who have certain medical conditions or who are undergoing certain medical procedures that increase the chance that clots will form.
What disease does heparin treat?
Heparin is a blood thinner that's used to treat and prevent blood clots. These can include venous thrombosis, pulmonary embolism, and peripheral arterial embolism.
Who should not take heparin?
You should not use heparin if you have uncontrolled bleeding or a severe lack of platelets in your blood, or if you have ever had low platelets caused by using heparin or pentosan polysulfate. Do not use heparin injection to flush (clean out) an intravenous (IV) catheter, or fatal bleeding could result.
What are side effects of heparin?
AdvertisementAbdominal or stomach pain or swelling.back pain or backaches.bleeding from the gums when brushing teeth.blood in the urine.coughing up blood.headaches, severe or continuing.heavy bleeding or oozing from cuts or wounds.joint pain, stiffness, or swelling.More items...•
How long does it take for heparin to dissolve blood clots?
IV heparin works rapidly; within minutes of receiving it, most patients have excellent anticoagulation that will prevent further clotting. However, patients who get heparin must be monitored every day with a blood test to see if the correct dose is being given.
Will heparin dissolve blood clots?
Anticoagulants, such as heparin, warfarin, dabigatran, apixaban, and rivaroxaban, are medications that thin the blood and help to dissolve blood clots.
Can heparin cause a stroke?
Heparin-induced thrombocytopenia (HIT) is an adverse effect of heparin therapy which can be responsible for thrombotic events with embolic consequences. Although ischemic stroke is a well known consequence of HIT, few cases of cerebral ischemia of arterial origin have been reported so far.
How long does heparin last for?
Type I is frequent, mild (usually >50 x 109/L) and transient, occurring within 1-5 days of heparin administration....Hide table of contents.2 hours pre-operatively:5,000 units subcutaneouslyfollowed by:5,000 units subcutaneously every 8-12 hours, for 7-10 days or until the patient is fully ambulant.
What is the most serious potential side effect of heparin therapy?
Get medical help right away if you have any very serious side effects, including: pain/loss of feeling in the arms/legs, change in color of the arms/legs, chest pain, trouble breathing, confusion, weakness on one side of the body, slurred speech, vision changes. A very serious allergic reaction to this drug is rare.
Can you go home on heparin?
Heparin is a blood‐thinning drug that is used to treat DVT during the first three to five days. Unfractionated heparin (UFH) is administered intravenously in hospital with laboratory monitoring. Low molecular weight heparins (LMWHs) are given by subcutaneous injection once a day and can be given at home.
Where do you inject heparin?
Heparin is a type of medication that stops the blood from clotting. You administer heparin to yourself at home by injection directly into the fleshy part of your stomach or thigh.
What Is Heparin Injection?
Heparin is an anticoagulant (blood thinner) that prevents the formation of blood clots.Heparin is used to treat and prevent blood clots caused by c...
Before Taking This Medicine
You should not use this medicine if you are allergic to heparin or pork products, or if you have: 1. a severe lack of platelets in your blood; or 2...
How Should I Use Heparin Injection?
Heparin is injected under the skin or into a vein through an IV. You may be shown how to use injections at home. Do not give yourself this medicine...
What Happens If I Overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.Overdose symptoms may include easy bruising, nosebleeds, blood in y...
What Should I Avoid While Using Heparin Injection?
Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprof...
Heparin Injection Side Effects
Get emergency medical help if you have signs of an allergic reaction to heparin: nausea, vomiting, sweating, hives, itching, trouble breathing, swe...
Heparin Dosing Information
Usual Adult Dose of Heparin for Deep Vein Thrombosis:The manufacturer provides the following dosing guidelines based on clinical experience:Continu...
What Other Drugs Will Affect Heparin Injection?
Using certain medicines with heparin can cause you to bleed more easily. This includes prescription and over-the-counter medicines, vitamins, and h...
What is heparin used for?
As a medication it is used as an anticoagulant. Specifically it is also used in the treatment of heart attacks and unstable angina. It is given by injection into a vein or under the skin.
Why is heparin given intravenously?
Heparin is given parenterally because it is not absorbed from the gut, due to its high negative charge and large size. It can be injected intravenously or subcutaneously (under the skin); intramuscular injections (into muscle) are avoided because of the potential for forming hematomas. Because of its short biologic half-life of about one hour, heparin must be given frequently or as a continuous infusion. Unfractionated heparin has a half-life of about one to two hours after infusion, whereas LMWH has a half-life of four to five hours. The use of LMWH has allowed once-daily dosing, thus not requiring a continuous infusion of the drug. If long-term anticoagulation is required, heparin is often used only to commence anticoagulation therapy until an oral anticoagulant e.g. warfarin takes effect.
Why is heparin complex?
The three-dimensional structure of heparin is complicated because iduronic acid may be present in either of two low-energy conformations when internally positioned within an oligosaccharide. The conformational equilibrium is influenced by sulfation state of adjacent glucosamine sugars.
How long does heparin last?
Unfractionated heparin has a half-life of about one to two hours after infusion, whereas LMWH has a half-life of four to five hours.
How many people died from heparin?
According to the FDA, the adulterated heparin killed nearly 80 people in the United States. The adulterant was identified as an "over-sulphated" derivative of chondroitin sulfate, a popular shellfish-derived supplement often used for arthritis, which was intended to substitute for actual heparin in potency tests.
Why did Dennis Quaid overdose on heparin?
The overdose allegedly arose because the labeling and design of the adult and infant versions of the product were similar. The Quaid family subsequently sued the manufacturer, Baxter Healthcare Corp., and settled with the hospital for $750,000. Prior to the Quaid accident, six newborn babies at Methodist Hospital in Indianapolis, Indiana, were given an overdose. Three of the babies died after the mistake.
What is the side effect of heparin?
A serious side-effect of heparin is heparin-induced thrombocytopenia (HIT), caused by an immunological reaction that makes platelets a target of immunological response, resulting in the degradation of platelets, which causes thrombocytopenia.
How it works
Heparin belongs to a class of drugs called anticoagulants. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
Serious side effects
Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
Interactions that can increase your risk of side effects
Taking heparin with certain drugs can increase your risk of bleeding and make you bruise more easily. Examples of these drugs include:
Interactions that can make heparin less effective
When used with heparin, certain drugs can make heparin less effective. Examples of these drugs include:
Warnings for people with certain health conditions
For people with pig protein sensitivity: Do not take this drug. This drug is made from pork tissue and can cause a life-threatening allergic reaction in people who are sensitive or allergic to other pig proteins.
Warnings for other groups
For pregnant women: Research in animals has shown negative effects to the fetus when the mother uses heparin. However, there haven’t been enough studies done in humans to be certain how the drug might affect the fetus.
Dosage for deep vein thrombosis and pulmonary embolism
Typical starting dosage: 333 units/kg of body weight injected under your skin.
What is heparin injection?
Descriptions. Heparin injection is an anticoagulant. It is used to decrease the clotting ability of the blood and help prevent harmful clots from forming in blood vessels. This medicine is sometimes called a blood thinner, although it does not actually thin the blood.
Why is heparin used in surgery?
Heparin is also used to prevent blood clotting during open-heart surgery, bypass surgery, kidney dialysis, and blood transfusions. It is used in low doses to prevent the formation of blood clots in certain patients, especially those who must have certain types of surgery or who must remain in bed for a long time.
How is heparin given?
The drug heparin is sometimes given as an infusion through an IV line. It is important to have your blood drawn and tested to get the correct amount of heparin in your blood. Your medical team will check to see how well heparin is working with a test called the partial thromboplastin time (PTT).
What is heparin infusion?
Heparin is a drug that helps to prevent blood clots. A heparin infusion delivers heparin through an IV line in your vein. Side effects include bruising and unexpected bleeding.
What is the first treatment for a blood clot?
Heparin may be the first treatment you get if you have a venous thromboembolism (VTE), also known as a blood clot. Such clots can be serious. You might have a clot in a deep vein, like one in the leg or arm. This is called a deep vein thrombosis or DVT. If the DVT breaks loose from the wall of the vein and travels to the lungs, ...
Why do you need heparin?
You may also get heparin to prevent blood clots after procedures, surgeries, or injuries that keep you from being able to move around, such as joint replacement surgeries .
What are the side effects of heparin?
Call your doctor or notify your nurse if you are taking heparin and you have these side effects: Trouble breathing, fast breathing or wheezing. Bleeding that will not stop. Bruising, rash or patches on the skin. Rash or patches on the skin. Sudden weakness or numbness on one side of the body.
What is IV line?
Veins are the most common type of blood vessels used. When a catheter is placed in a vein it is called an "IV line.".
What is it called when a vein breaks?
This is called a deep vein thrombosis or DVT. If the DVT breaks loose from the wall of the vein and travels to the lungs, it is called a pulmonary embolism (PE). PEs can cut off some or all of the blood supply in the lungs. A blood clot could even travel to the brain, causing a stroke. This is why treatment is needed.
What are the three elements that make up the precursor molecule of heparin?
There are three distinct chemical elements that make up the heparin precursor molecule: Mucopolysaccharides, amino acids, and sugars. Separate from the chemical elements are three unique domains of activity tha ….
What is the anticoagulant agent that inhibits thrombosis?
The anticoagulant agent heparin inhibits thrombosis by interacting with antithrombin III. There are three distinct chemical elements that make up the heparin precursor molecule: Mucopolysaccharides, amino acids, and sugars. Separate from the chemical elements are three unique domains of activity that have been defined based on ...
What are the side effects of heparin in the bladder?
The side effects of bladder instillation of heparin are limited primarily to pain, irritation, or discomfort resulting from frequent catheterization. Revised Monday, July 6th, 2015.
How long does heparin stay in the bladder?
A heparin solution of 10,000 units diluted with saline solution is instilled intravesically daily, and held in the bladder for 20 to 30 minutes.
How long does it take for a syringe to work?
It takes 3 to 6 months to begin to see improvement, but therapy should continue for at least 12 months. If there is no improvement in symptoms after 3 months, the dosage is increased to 20,000 units. Therapy can be continued indefinitely.
Can heparin be given instillation?
While this drug can be given either by injection or by bladder instillation, the method of choice for the treatment of IC is bladder instillation. It can be used as a primary treatment method, as a component of an instilled “bladder cocktail” or as a “maintenance medicine” to supplement other types of treatment. Heparin is also combined with alkalinized lidocaine to form a “rescue remedy” for use during IC flares.
Does heparin help with DMSO?
Another study of patients undergoing DMSO treatments indicated that heparin might help reduce their relapse rate. Patients treated with DMSO alone had a relapse rate of 52 percent, while those maintained with monthly instillations of heparin and followed for 12 months had a relapse rate of 20 percent.
Usual Adult Dose for Deep Vein Thrombosis
The manufacturer provides the following dosing guidelines based on clinical experience: Continuous IV infusion: -Initial dose: 5000 units by IV injection -Maintenance dose: 20,000 to 40,000 units per 24 hours by continuous IV infusion Intermittent IV injection: -Initial dose: 10,000 units IV -Maintenance dose: 5000 to 10,000 units IV every 4 to 6 hours Deep subcutaneous (intrafat) injection: 333 units/kg subcutaneously followed by 250 units/kg subcutaneously every 12 hours; the following dosage regimen has also been recommended: 5000 units by IV injection followed by 10,000 to 20,000 units subcutaneously, and then 8000 to 10,000 units subcutaneously every 8 hours or 15,000 to 20,000 units subcutaneously every 12 hours. Comments: -Recommended doses are based on a 68 kg patient. -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Uses: -Prophylaxis and treatment of venous thrombosis and pulmonary embolism. -Prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation. -Treatment of acute and chronic consumption coagulopathies (disseminated intravascular coagulation). -Prophylaxis and treatment of peripheral arterial embolism. 5000 units subcutaneously 2 hours before surgery and 5000 units subcutaneously every 8 to 12 hours thereafter for 7 days or until the patient is ambulatory, whichever is longer. Comments: -Administer by deep subcutaneous (intrafat, e.g., above the iliac crest or abdominal fat layer, arm, or thigh) injection with a fine (25 to 26 gauge) needle to minimize tissue trauma. -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Use: Low-dose regimen for prevention of postoperative deep venous thrombosis and pulmonary embolism in patients greater than 40 years old undergoing major abdominothoracic surgery or who, for other reasons, are at risk of developing thromboembolic disease..
Usual Adult Dose for Deep Vein Thrombosis - Prophylaxis
The manufacturer provides the following dosing guidelines based on clinical experience: Continuous IV infusion: -Initial dose: 5000 units by IV injection -Maintenance dose: 20,000 to 40,000 units per 24 hours by continuous IV infusion Intermittent IV injection: -Initial dose: 10,000 units IV -Maintenance dose: 5000 to 10,000 units IV every 4 to 6 hours Deep subcutaneous (intrafat) injection: 333 units/kg subcutaneously followed by 250 units/kg subcutaneously every 12 hours; the following dosage regimen has also been recommended: 5000 units by IV injection followed by 10,000 to 20,000 units subcutaneously, and then 8000 to 10,000 units subcutaneously every 8 hours or 15,000 to 20,000 units subcutaneously every 12 hours. Comments: -Recommended doses are based on a 68 kg patient. -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Uses: -Prophylaxis and treatment of venous thrombosis and pulmonary embolism. -Prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation. -Treatment of acute and chronic consumption coagulopathies (disseminated intravascular coagulation). -Prophylaxis and treatment of peripheral arterial embolism. 5000 units subcutaneously 2 hours before surgery and 5000 units subcutaneously every 8 to 12 hours thereafter for 7 days or until the patient is ambulatory, whichever is longer. Comments: -Administer by deep subcutaneous (intrafat, e.g., above the iliac crest or abdominal fat layer, arm, or thigh) injection with a fine (25 to 26 gauge) needle to minimize tissue trauma. -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Use: Low-dose regimen for prevention of postoperative deep venous thrombosis and pulmonary embolism in patients greater than 40 years old undergoing major abdominothoracic surgery or who, for other reasons, are at risk of developing thromboembolic disease..
Usual Adult Dose for Prevention of Thromboembolism in Atrial Fibrillation
The manufacturer provides the following dosing guidelines based on clinical experience: Continuous IV infusion: -Initial dose: 5000 units by IV injection -Maintenance dose: 20,000 to 40,000 units per 24 hours by continuous IV infusion Intermittent IV injection: -Initial dose: 10,000 units IV -Maintenance dose: 5000 to 10,000 units IV every 4 to 6 hours Deep subcutaneous (intrafat) injection: 333 units/kg subcutaneously followed by 250 units/kg subcutaneously every 12 hours; the following dosage regimen has also been recommended: 5000 units by IV injection followed by 10,000 to 20,000 units subcutaneously, and then 8000 to 10,000 units subcutaneously every 8 hours or 15,000 to 20,000 units subcutaneously every 12 hours. Comments: -Recommended doses are based on a 68 kg patient. -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Uses: -Prophylaxis and treatment of venous thrombosis and pulmonary embolism. -Prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation. -Treatment of acute and chronic consumption coagulopathies (disseminated intravascular coagulation). -Prophylaxis and treatment of peripheral arterial embolism. 5000 units subcutaneously 2 hours before surgery and 5000 units subcutaneously every 8 to 12 hours thereafter for 7 days or until the patient is ambulatory, whichever is longer. Comments: -Administer by deep subcutaneous (intrafat, e.g., above the iliac crest or abdominal fat layer, arm, or thigh) injection with a fine (25 to 26 gauge) needle to minimize tissue trauma. -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Use: Low-dose regimen for prevention of postoperative deep venous thrombosis and pulmonary embolism in patients greater than 40 years old undergoing major abdominothoracic surgery or who, for other reasons, are at risk of developing thromboembolic disease..
Usual Adult Dose for Pulmonary Embolism
The manufacturer provides the following dosing guidelines based on clinical experience: Continuous IV infusion: -Initial dose: 5000 units by IV injection -Maintenance dose: 20,000 to 40,000 units per 24 hours by continuous IV infusion Intermittent IV injection: -Initial dose: 10,000 units IV -Maintenance dose: 5000 to 10,000 units IV every 4 to 6 hours Deep subcutaneous (intrafat) injection: 333 units/kg subcutaneously followed by 250 units/kg subcutaneously every 12 hours; the following dosage regimen has also been recommended: 5000 units by IV injection followed by 10,000 to 20,000 units subcutaneously, and then 8000 to 10,000 units subcutaneously every 8 hours or 15,000 to 20,000 units subcutaneously every 12 hours. Comments: -Recommended doses are based on a 68 kg patient. -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Uses: -Prophylaxis and treatment of venous thrombosis and pulmonary embolism. -Prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation. -Treatment of acute and chronic consumption coagulopathies (disseminated intravascular coagulation). -Prophylaxis and treatment of peripheral arterial embolism. 5000 units subcutaneously 2 hours before surgery and 5000 units subcutaneously every 8 to 12 hours thereafter for 7 days or until the patient is ambulatory, whichever is longer. Comments: -Administer by deep subcutaneous (intrafat, e.g., above the iliac crest or abdominal fat layer, arm, or thigh) injection with a fine (25 to 26 gauge) needle to minimize tissue trauma. -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Use: Low-dose regimen for prevention of postoperative deep venous thrombosis and pulmonary embolism in patients greater than 40 years old undergoing major abdominothoracic surgery or who, for other reasons, are at risk of developing thromboembolic disease..
Usual Adult Dose for Disseminated Intravascular Coagulation
The manufacturer provides the following dosing guidelines based on clinical experience: Continuous IV infusion: -Initial dose: 5000 units by IV injection -Maintenance dose: 20,000 to 40,000 units per 24 hours by continuous IV infusion Intermittent IV injection: -Initial dose: 10,000 units IV -Maintenance dose: 5000 to 10,000 units IV every 4 to 6 hours Deep subcutaneous (intrafat) injection: 333 units/kg subcutaneously followed by 250 units/kg subcutaneously every 12 hours; the following dosage regimen has also been recommended: 5000 units by IV injection followed by 10,000 to 20,000 units subcutaneously, and then 8000 to 10,000 units subcutaneously every 8 hours or 15,000 to 20,000 units subcutaneously every 12 hours. Comments: -Recommended doses are based on a 68 kg patient. -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Uses: -Prophylaxis and treatment of venous thrombosis and pulmonary embolism. -Prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation. -Treatment of acute and chronic consumption coagulopathies (disseminated intravascular coagulation). -Prophylaxis and treatment of peripheral arterial embolism. 5000 units subcutaneously 2 hours before surgery and 5000 units subcutaneously every 8 to 12 hours thereafter for 7 days or until the patient is ambulatory, whichever is longer. Comments: -Administer by deep subcutaneous (intrafat, e.g., above the iliac crest or abdominal fat layer, arm, or thigh) injection with a fine (25 to 26 gauge) needle to minimize tissue trauma. -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Use: Low-dose regimen for prevention of postoperative deep venous thrombosis and pulmonary embolism in patients greater than 40 years old undergoing major abdominothoracic surgery or who, for other reasons, are at risk of developing thromboembolic disease..
Usual Adult Dose for Venous Thromboembolism
The manufacturer provides the following dosing guidelines based on clinical experience: Continuous IV infusion: -Initial dose: 5000 units by IV injection -Maintenance dose: 20,000 to 40,000 units per 24 hours by continuous IV infusion Intermittent IV injection: -Initial dose: 10,000 units IV -Maintenance dose: 5000 to 10,000 units IV every 4 to 6 hours Deep subcutaneous (intrafat) injection: 333 units/kg subcutaneously followed by 250 units/kg subcutaneously every 12 hours; the following dosage regimen has also been recommended: 5000 units by IV injection followed by 10,000 to 20,000 units subcutaneously, and then 8000 to 10,000 units subcutaneously every 8 hours or 15,000 to 20,000 units subcutaneously every 12 hours. Comments: -Recommended doses are based on a 68 kg patient. -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Uses: -Prophylaxis and treatment of venous thrombosis and pulmonary embolism. -Prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation. -Treatment of acute and chronic consumption coagulopathies (disseminated intravascular coagulation). -Prophylaxis and treatment of peripheral arterial embolism. 5000 units subcutaneously 2 hours before surgery and 5000 units subcutaneously every 8 to 12 hours thereafter for 7 days or until the patient is ambulatory, whichever is longer. Comments: -Administer by deep subcutaneous (intrafat, e.g., above the iliac crest or abdominal fat layer, arm, or thigh) injection with a fine (25 to 26 gauge) needle to minimize tissue trauma. -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Use: Low-dose regimen for prevention of postoperative deep venous thrombosis and pulmonary embolism in patients greater than 40 years old undergoing major abdominothoracic surgery or who, for other reasons, are at risk of developing thromboembolic disease..
Usual Adult Dose for Cardiothoracic Surgery
Initial dose: At least 150 units/kg; frequently, 300 units/kg is used for procedures estimated to last less than 60 minutes or 400 units/kg for those estimated to last longer than 60 minutes. Comments: -Consult the latest guidelines regarding duration and intensity of anticoagulation for the indicated conditions. -Dosage and administration must be individualized according to the results of suitable laboratory tests. Uses: -Prevention of clotting in arterial and cardiac surgery. -Total body perfusion for open-heart surgery..
Overview
Heparin, also known as unfractionated heparin (UFH), is a medication and naturally occurring glycosaminoglycan. Since heparins depend on the activity of antithrombin, they are considered anticoagulants. Specifically it is also used in the treatment of heart attacks and unstable angina. It is given by injection into a vein or under the skin. Other uses include inside test tubes and kidney dialysis m…
History
Heparin was discovered by Jay McLean and William Henry Howell in 1916, although it did not enter clinical trials until 1935. It was originally isolated from dog liver cells, hence its name (hepar or "ήπαρ" is Greek for "liver"; hepar + -in).
McLean was a second-year medical student at Johns Hopkins University, and was working under the guidance of Howell investigating pro-coagulant preparations, when he isolated a fat-soluble …
Medical use
Heparin acts as an anticoagulant, preventing the formation of clots and extension of existing clots within the blood. While heparin itself does not break down clots that have already formed (unlike tissue plasminogen activator), it allows the body's natural clot lysis mechanisms to work normally to break down clots that have formed. Heparin is generally used for anticoagulation for the fo…
Adverse effects
A serious side-effect of heparin is heparin-induced thrombocytopenia (HIT), caused by an immunological reaction that makes platelets a target of immunological response, resulting in the degradation of platelets, which causes thrombocytopenia. This condition is usually reversed on discontinuation, and in general can be avoided with the use of synthetic heparins. Also, a benign form of thrombocytopenia is associated with early heparin use, which resolves without stoppin…
Physiological function
Heparin's normal role in the body is unclear. Heparin is usually stored within the secretory granules of mast cells and released only into the vasculature at sites of tissue injury. It has been proposed that, rather than anticoagulation, the main purpose of heparin is defense at such sites against invading bacteria and other foreign materials. In addition, it is observed across a number of widely different species, including some invertebrates that do not have a similar blood coagul…
Pharmacology
In nature, heparin is a polymer of varying chain size. Unfractionated heparin (UFH) as a pharmaceutical is heparin that has not been fractionated to sequester the fraction of molecules with low molecular weight. In contrast, low-molecular-weight heparin (LMWH) has undergone fractionation for the purpose of making its pharmacodynamics more predictable. Often either UFH or LMWH can be us…
Chemistry
Native heparin is a polymer with a molecular weight ranging from 3 to 30 kDa, although the average molecular weight of most commercial heparin preparations is in the range of 12 to 15 kDa. Heparin is a member of the glycosaminoglycan family of carbohydrates (which includes the closely related molecule heparan sulfate) and consists of a variably sulfated repeating disacch…
Other functions
• Test tubes, vacutainers, and capillary tubes that use the lithium salt of heparin (lithium heparin) as an anticoagulant are usually marked with green stickers and green tops. Heparin has the advantage over EDTA of not affecting levels of most ions. However, the concentration of ionized calcium may be decreased if the concentration of heparin in the blood specimen is too high. Heparin can interfere with some immunoassays, however. As lithium heparin is usually used, a p…