Unfractionated heparin: Difference between revisions
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==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: Safe in pregnancy | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: Safe in pregnancy | ||
*Lactation: | *Lactation: | ||
*Renal Dosing | *Renal Dosing | ||
** | **No adjustment | ||
*Hepatic Dosing | *Hepatic Dosing | ||
** | **No adjustment | ||
==Contraindications== | ==Contraindications== |
Revision as of 17:21, 6 March 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
- Allergy to class/drug
- 33% of pts develop some form of bleeding complication; 2-6% develop major bleeding
- Heparin-Induced Thrombocytopenia
- See HIT (Heparin-Induced Thrombocytopenia)
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:
- Metabolism:
- Excretion:
- 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