Heparin

Details About Generic Salt ::  Heparin 

Main Medicine Class:: Hematological System   Sub Medicine Class ::  Anti Coagulants

5B. ANTI-COAGULANTS in 5. HEMATOLOGICAL SYSTEM
HEPARIN
ANTI-THROMBOTIC | ANTI-COAGULANT
PK: A: Not absorbed M: Hepatic E: Urine

Indications & Dose: ACUTE PERIPHERAL ARTERIAL EMBOLISM IV Adult Loading dose of 5000 units followed by continuous Inf 1000-2000 units/h | SC Adult 15000 units BID | CARDIAC CATHETERIZATION Prophylactic therapy IV Child >1 yr: 100-150U/kg given as bolusarterial approach | DEEP VEIN THROMBOSIS/PULMONARY EMBOLISM IV Adult 80units/kg (5, 000U) IV push, then 18U/kg/h (1, 300U/h) by continuous Inf | SC Adult Initially 17, 500U or 250U/kg, then 250U/kg BID | POST-OPERATIVE VENOUS THROMBOEMBOLISM Prophylactic therapy SC Adult 5000U 2h before surgery then q8-12h 7days or until patient is ambulant | RE-OCCLUSION OF CORONARY ARTERIES Prophylactic therapy IV Adult 5, 000U followed by alteplase therapy (1, 000U/h) | SYSTEMIC HEPARINIZATION IV Child Loading dose: 75U/kg over 10 min MD initially 20U/kg/h, adjust dose to maintain aPTT of 60-85 sec | THROMBOEMBOLISM DURING PREGNANCY Prophylactic therapy SC Adult 5000U 2h before surgery then q8-12h 7days, the dose may be increased to 10, 000U BID during third trimesterwith history of DVT/PE | THROMBOPROPHYLAXIS IV Adult Initially 10, 000U followed by 50-70U/kg (5, 000-10, 000U) q4-6h | UNSTABLE ANGINA IV Adult Loading dose of 5000units followed by continuous Inf 1000-2000 units/h | VENOUS THROMBOEMBOLISM SC Adult 15, 000U BID

Contra: Hypersensitivity, severe thrombocytopenia, uncontrolled active bleeding, hemophilia & other hemorrhagic disorders, PUD, recent cerebral hemorrhage, severe HTN, severe hepatic/renal diseases, acute bacterial endocarditis, after major trauma/recent surgery

Precautions: Hepatic impairment, renal failure, elderly, hypersensitivity to low molecular weight heparins, spinal/epidural anesthesia, acidosis, concomitant use of potassium-sparing drugs, DM

ADR: Serious: Immune-mediated thrombocytopenia, hemorrhage, hypersensitivity reactions, angioedema, anaphylaxis, osteoporosis, Others: urticaria, alopecia, chills, fever, pruritus, rhinitis, local irritation, erythema, cutaneous & subcutaneous necrosis, ulceration

DDI: Serious Glycoprotein IIb/IIIa antagonists/antiplatelet/NSAIDs increases risk of bleeding, Aspirin increases risk of haemorrhage, ACEIs increases risk of hyperkalemia, Dextrans prolongs clotting time & increase risk of bleeding

Monitor: Hemoglobin, hematocrit, signs of bleeding, fecal occult blood test, platelet count, activated clotting time

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