Difference between revisions of "Unfractionated heparin"

Revision as of 22:56, 17 January 2015

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)

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

Authors:

@@ Line 25: / Line 25: @@
 ==Contraindications==
 *Allergy to class/drug
-#Bleeding
+*33% of pts develop some form of bleeding complication; 2-6% develop major bleeding
-##Treatment
+*Heparin-Induced Thrombocytopenia
-###Managed according to clinical severity, NOT PTT value
+*See [[HIT (Heparin-Induced Thrombocytopenia)]]
-####Heparin-associated bleeding is not always reflected by a supratherapeutic PTT
-###Stop transfusion
-###Observation alone may be appropriate in less severe cases
-###Protamine
-####Only indicated for major bleeding (0.2% of pts develop severe anaphylaxis)
-####Give 1mg IV for every 100 units of UFH infused in the prior 3hr
-####Give slowly over 1-3min; do not exceed 50mg in any 10 minute period
-####Because half-life is short (7 min) may require second treatment
-###Massive bleed
-####Cryoprecipitate (10 U IV), then FFP (& platelets, aminocaproic acid infusion if nec)
-#Heparin-Induced Thrombocytopenia
-##See [[HIT (Heparin-Induced Thrombocytopenia)]]
 ===Risk Factors for Major Bleeding Complication===
@@ Line 61: / Line 49: @@
 **Unpredictable anticoagulation effect
 **Must monitor w/ PTT; therapeutic range is 1.5-2.5x normal value
-*33% of pts develop some form of bleeding complication; 2-6% develop major bleeding
 ==See Also==
 *[[Coagulopathy (Main)]]
 *[[Low Molecular Weight Heparin]]
+*[[Heparin reversal]]
 ==Sources==