Heparin

Heparin sodium                                                       preg risk C

Indications/actions: prevention of deep vein thrombosis, MI, pulmonary embolism. Accelerates formation of antithrombin III complex, and deactivates thrombin, preventing conversion of fibrinogen to fibrin. Interfere with the normal cascade of events involved in the clotting process.

Parenteral

Adverse:

Haematologic: haemorrhage(excess dose), ^clotting time,thrombocytopenia, white clot syndrome

Skin: cutaneous or SC necrosis
GI upset

Other: irritation, mild pain, haematoma, ulceration, hypersensitivity reactions(chills, fever pururitus, rhinitis, urticaria) anaphylactoid reactions

Drug-drug: oral anticoagulants. Increased additive anticoagulation. Monitor PT INR and PTT. Salicylates, antiplatelet drugs. Thrombolytics- increased bleeding risk. Don’t need to learn drug to drug- lecture

Drug-herb: garlic, ginkgo, motherwort, red clover, whte willow. ^bleeding risk.

Contraindications: hypersensitivity, active bleeding, blood dyscrasias, thrombophlebitis, inaccessible ulcerative lesions(eg GI), open ulcerations,ascorbic acid deficiency

Care considerations:

·         Use caution where there is mild hepatic or renal disease, alcoholism, allergies, asthma, or GI ulcerations, immediately postpartum.

·         Check order and vial carefully- there are various concentrations.

·         Give low dose injections sequentially between iliac crests in lower abdomen deep into SC fat. Inject slowly, leave needle in for 10 seconds after injection, then with draw. Do not massage aftter SC, watch for signs of bleeding at injection site. Alternates sites.

Alert: to treat severe heparin calcium or sodium over dose use protamine sulfate