Subcut / IV
Heparin Sodium
- Mechanism of Action
- Binds to and activates antithrombin III, which as a heparin-ATIII complex inactivates factors IIa (thrombin) and Xa
- Pharmacology
- Variable bioavailability, non-linear pharmacokinetics and unpredictable response.
- Effective half-life is 90 minutes subcutaneously, or 30 minutes intravenously.
- Reversed with protamine sulfate.
Clinical Use
- Indications
- Prevention of venous thromboembolism (DVT / PE)
- Treatment of venous thromboembolism (DVT / PE)
- ST elevation myocardial infarction (STEMI)
- Bridging anticoagulation for initiation / withholding of warfarin
- Prevention of thrombosis during haemodialysis
- Acute limb ischaemia (unfractionated heparin)
- Adverse Effects
- Haemorrhage
- Heparin-induced thrombocytopaenia (HIT) - thrombocytopaenia with arterial and venous thrombosis
- Hypersensitivity
- Skin necrosis
- Monitoring
- Intravenous heparin is monitored using activated partial thromboplastin time (APTT). Alternatively (particularly in the setting of antiphospholipid syndrome), a heparin anti-factor Xa assay can be used.
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