Difference between revisions of "Unfractionated heparin"

(PCI)
(Risk Factors for Major Bleeding Complication)
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===Risk Factors for Major Bleeding Complication===
 
===Risk Factors for Major Bleeding Complication===
#Recent surgery or trauma
+
*Recent surgery or trauma
#Renal failure
+
*Renal failure
#Alcoholism
+
*Alcoholism
#Malignancy
+
*Malignancy
#Liver failure
+
*Liver failure
#Concurrent use of warfarin, fibrinolytics, steroids, or antiplatelet drugs
+
*Concurrent use of warfarin, fibrinolytics, steroids, or antiplatelet drugs
  
 
==Pharmacology==
 
==Pharmacology==

Revision as of 17:21, 29 June 2016

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

PCI

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

  • Pregnancy Rating: Safe in pregnancy
  • Lactation:
  • Renal Dosing
    • No adjustment
  • Hepatic Dosing
    • No adjustment

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 w/ PTT; therapeutic range is 1.5-2.5x normal value

See Also

References