Heparin

A to Z Drug Facts

Heparin

  Action
  Indications
  Contraindications
  Route/Dosage
  Interactions
  Lab Test Interferences
  Adverse Reactions
  Precautions
Patient Care Considerations
  Administration/Storage
  Assessment/Interventions
  Patient/Family Education


(HEP-uh-rin)
Heparin Sodium, Hep-Lock, Hep-Lock U/P, Hepalean, Hepalean-Lok, Heparin Leo, Heparin Lock Flush
Class: Anticoagulant

 Action Inhibits reactions that lead to clotting.

 Indications Prophylaxis and treatment of venous thrombosis and its extensions, pulmonary embolism (PE), peripheral arterial embolism, and atrial fibrillation with embolization; diagnosis and treatment of acute and chronic consumption coagulopathies (DIC); prevention of postoperative deep venous thrombosis(DVT), and PE. Unlabeled use (s): Prophylaxis of left ventricular thrombi and cerebrovascular accidents post-MI; treatment of myocardial ischemia; prevention of cerebral thrombosis in evolving strokes; adjunctive treatment of coronary occlusion with acute MI.

 Contraindications Severe thrombocytopenia; uncontrolled bleeding (except due to DIC); patients in whom suitable blood coagulation tests cannot be performed.

 Route/Dosage

ADULTS: SC 10,000 to 20,000 U as initial dose followed by 8000 to 20,000 U q 8 to 12 hr. Intermittent IV 10,000 U as initial dose followed by 5000 to 10,000 U q 4 to 6 hr. IV infusion 20,000 to 40,000 U/day. CHILDREN: Intermittent IV 50 U/kg as initial dose followed by 100 U/kg q 4 hr. IV infusion 50 U/kg as initial dose followed by 20,000 U/m2/24 hr.

Low-dose Prophylaxis

SC 5000 U 2 hr before surgery and q 8 to 12 hr thereafter for 7 days or until patient is fully ambulatory, whichever is longer.

Surgery of Heart and Blood Vessels

ADULTS: 300 to 400 U/kg.

Blood Transfusion

Add 400 to 600 U/100 ml of whole blood.

Clearing Intermittent Infusion Sets

10 to 100 U/ml.

Laboratory Samples

Add 70 to 150 U/10 to 20 ml of whole blood.

 Interactions

Dipyridamole, hydroxychloroquine, NSAIDs, salicylates: May cause increased risk of bleeding. INCOMPAT IBILITIES: Heparin is acidic and incompatible with many drugs.

 Lab Test Interferences Aminotransferase (AST and ALT): Drug causes increased concentrations.

 Adverse Reactions

DERM: Necrosis; transient alopecia; urticaria. HEMA: Hemorrhage; thrombocytopenia. OTHER: Hypersensitivity (chills, fever, urticaria, asthma, rhinitis, lacrimation, headache, nausea, vomiting, shock); anaphylactoid reactions; allergic vasospastic reactions, including painful ischemia, cyanotic limbs; osteoporosis; priapism; rebound hyperlipidemia on discontinuation.

 Precautions

Pregnancy: Category C. Lactation: Not excreted in breast milk. Elderly or debilitated patients: Higher incidence of bleeding in women > 60 yr. Benzyl alcohol sensitivity: Benzyl alcohol, used as preservative in some products, is associated with a fatal gasping syndrome in premature infants. IM use: Avoid IM use because of local irritation, erythema, pain, hematoma, or ulceration. Hypersensitivity: Generalized hypersensitivity can occur. Reactions range from mild to severe. Hemorrhage: Hemorrhage can occur at virtually any site. Use heparin with extreme caution in patients at increased risk of hemorrhage. Hyperlipidemia: Heparin administration may cause hyperlipidemia in patients with dysbetalipoproteinemia (type III).


PATIENT CARE CONSIDERATIONS


 Administration/Storage

 Assessment/Interventions

OVERDOSAGE: SIGNS & SYMPTOMS
  Bleeding, nosebleeds, hematuria, tarry stools, easy bruising, or petechiae

 Patient/Family Education

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Copyright
© 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts