Heparin sodium injection

dr.joandr.joan عضو ماسي
تم تعديل 2009/06/28 في أدوية الطوارئ Emergency drugs
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:
  • Hemorrhage.
Overdose:
v Nose bleeds ,
v Hematuria,
v Petechiae , and
v Tarry stool.
Antidote:
  • Protamin sulfate.
Dose:

§ 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.