Brand Name: heparin sodium injection, Hepalean (CAN), Heparin Leo (CAN)
Pregnancy Category C
Drug class: Anticoagulant,
Inhibits thrombus and clot formation by blocking the conversion of prothrombin to thrombin and fibrinogen to fibrin, the final steps in the clotting process.
· Prevention and treatment of venous thrombosis and pulmonary embolism
· Treatment of atrial fibrillation with embolization
· Diagnosis and treatment of DIC
· Prevention of clotting in blood samples and heparin lock sets and during dialysis procedures
· Unlabeled uses: adjunct in therapy of coronary occlusion with acute MI, prevention of left ventricular thrombi and CVA post-MI, prevention of cerebral thrombosis in the evolving stroke
· Hypersensitivity to heparin; severe thrombocytopenia; uncontrolled bleeding; any patient who cannot be monitored regularly with blood coagulation tests; labor and immediate postpartum period; women older than 60 yr are at high risk for hemorrhaging; dysbetalipoproteinemia; recent surgery or injury.
Loss of hair
Hemorrhage; bruising; thrombocytopenia; elevated AST, ALT levels, hyperkalemia
Chills, fever, urticaria, asthma
Osteoporosis, suppression of renal function (long-term, high-dose therapy)
· Increased bleeding tendencies with oral anticoagulants, salicylates, penicillins, cephalosporins
· Decreased anticoagulation effects if taken concurrently with nitroglycerin
· Adjust dose according to coagulation test results performed just before injection (30 min before each intermittent dose or q 4 hr if continuous IV dose). Therapeutic range APTT: 1.5–2.5 times control.
· Use heparin lock needle to avoid repeated injections.
· Give deep SC injections; do not give heparin by IM injection.
· Do not give IM injections to patients on heparin therapy (heparin predisposes to hematoma formation).
· Apply pressure to all injection sites after needle is withdrawn; inspect injection sites for signs of hematoma; do not massage injection sites.
· Mix well when adding heparin to IV infusion.
· Do not add heparin to infusion lines of other drugs, and do not piggyback other drugs into heparin line. If this must be done, ensure drug compatibility.
· Provide for safety measures (electric razor, soft toothbrush) to prevent injury from bleeding.
· Check for signs of bleeding; monitor blood tests.
· Alert all health care providers of heparin use.
· Have protamine sulfate (heparin antidote) on standby in case of overdose; each mg neutralizes 100 units of heparin.