Heparin sodium injection:
Trade names:
Hepalean, Heparin Leo
Heparin sodium and 0.9%
sodium chloride
Hepalean-Lok, Heparin Lock
Flush, Hep-Lock
Drug class
§ Anticoagulant
Class: anticoagulant
Pregnancy:
(Category B)
Action:
§ Anticoagulant
§ Potentiate the inhibitory action of antithrombin III on various coagulation factors.
§ Inactivate thrombin and prevent the conversion of fibrinogen to
fibrin.
Uses:
§ To prevent extension of clots.
§ To prevent thrombi and emboli from recurring.
§ Prophylactic from thromboembolic diseases.
§ After some types of surgery (cardiac & vascular).
§ Prevent clotting during hemodialysis.
§ Treatment of DIC (disseminated intravascular coagulation)
coronary occlusion after MI.
Contraindications:
ü Blood disorders with bleeding tendencies (hemophilia).
ü Suspected intracranial hemorrhage.
ü Open wounds.
ü During surgery of the eyes, brain and spinal cord.
ü Menstruation.
ü Abortion.
Side effects:
Overdose:
Antidote:
Dose:
|
§
Hemorrhage.
v
Nose bleeds ,
v
Hematuria,
v
Petechiae , and v Tarry stool.
§
Protamin sulfate.
§ IV or S.C measured in units according to
|
Bleeding
& clotting time
§ treatment of deep-vein thrombosis and
pulmonary embolism, by intravenous injection,
loading dose of 5000 units (10 000 units in
severe pulmonary embolism) followed by continuous infusion of 15–25 units/kg/hour or treatment of deep-vein
thrombosis, by subcutaneous injection of 15 000 units
every 12 hours (laboratory monitoring essential—preferably on a daily
basis, and dose adjusted accordingly)
SMALL ADULT OR CHILD, lower loading dose then, 15– 25
units/kg/hour by intravenous infusion, or 250 units/kg every 12 hours by
subcutaneous injection
Unstable angina, acute peripheral arterial occlusion,
as intravenous regimen for deep-vein thrombosis and pulmonary embolism,
Prophylaxis
in general surgery by subcutaneous injection, 5000
units 2 hours before surgery, then every 8–12
hours for 7 days or until patient is ambulant (monitoring not needed);
during pregnancy (with monitoring), 5000–10 000
units every 12 hours (important: not intended to cover prevention of prosthetic
heart valve thrombosis in pregnancy which calls for separate specialist
management)
§ Myocardial Infarction: For the
prevention of coronary re-occlusion after Thrombolysis heparin is used in a
variety of regimens according to locally agreed protocols
For the prevention of mural thrombosis
heparin is considered effective when given by subcutaneous injection of 12 500
units every 12 hours for at least 10 days
Nursing
considerations:
§ Should not be administered IM, administer by deep sc to minimize
local irritation and to prolong the action of drug.
§ Don’t massage before and after injection.
§ Change site of administration.
§ Instruct and stress the importance of reporting any signs of
active bleeding.
§ Use electric razor for shaving, soft bristle tooth brush to
decrease gum irritation.
§ Patient should be hospitalized for IV therapy.
§ Clotting time, PTT should be done before the start of therapy
each dose of drug then daily.
