Difference between revisions of "Unfractionated heparin"

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(Adult Dosing)
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==Adult Dosing==
 
==Adult Dosing==
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*See [https://depts.washington.edu/anticoag/home/content/heparin-infusion-guidelines University of Washington pharmacy heparin infusion guidelines]
 
===Thromboembolism===
 
===Thromboembolism===
 
*Bolus: 80 units/kg IV x 1 (MAX: 5,000 units)
 
*Bolus: 80 units/kg IV x 1 (MAX: 5,000 units)
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==Special Populations==
 
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: Safe in pregnancy
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*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*Lactation:  
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*[[Lactation risk categories|Lactation risk]]: Infant risk minimal
 
*Renal Dosing
 
*Renal Dosing
 
**No adjustment
 
**No adjustment
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*Must give IV (not subq) for acute thromboembolic disease
 
*Must give IV (not subq) for acute thromboembolic disease
 
**Unpredictable anticoagulation effect
 
**Unpredictable anticoagulation effect
**Must monitor w/ PTT; therapeutic range is 1.5-2.5x normal value
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**Must monitor with PTT; therapeutic range is 1.5-2.5x normal value
  
 
==See Also==
 
==See Also==
*[[Coagulopathy (Main)]]
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*[[Unfractionated heparin reversal]]
*[[Low Molecular Weight Heparin]]
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*[[Coagulopathy (main)]]
*[[Heparin reversal]]
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*[[Low molecular weight heparin]]
  
 
==References==
 
==References==

Revision as of 19:08, 20 April 2019

General

  • Type: Anticoagulant
  • Dosage Forms: IV, SC
  • Common Trade Names: Heparin

Adult Dosing

Thromboembolism

  • Bolus: 80 units/kg IV x 1 (MAX: 5,000 units)
  • Then drip: 18 units/kg/h IV (MAX: 1,000 units/h)
  • Adjust dose to target aPTT levels based on nomogram

Pediatric Dosing

  • IV infusion
    • Initial loading dose 75 units/kg given over 10 minutes
    • Initial maintenance dose 20 units/kg/hour and adjest per local policy

Special Populations

Contraindications

Risk Factors for Major Bleeding Complication

  • Recent surgery or trauma
  • Renal failure
  • Alcoholism
  • Malignancy
  • Liver failure
  • Concurrent use of warfarin, fibrinolytics, steroids, or antiplatelet drugs

Pharmacology

  • Half-life: 1.5 hrs
  • Metabolism: Hepatic
  • Excretion: Urine
  • Mechanism of Action:
    • Binds to and activates antithrombin which in turns inactivates factor Xa and thrombin
  • Anticoagulation effect lasts up to 3hr after stopping infusion
  • Must give IV (not subq) for acute thromboembolic disease
    • Unpredictable anticoagulation effect
    • Must monitor with PTT; therapeutic range is 1.5-2.5x normal value

See Also

References