Heparin initiates anticoagulation (stop clotting formation) rapidly but has a short duration of action. It inhibits reaction lead to clotting.
Counselling For Indications:
Many drugs are used for the treatment of different diseases however a single drug is also used for the treatment of many diseases.
Heparin is used for the treatment of following medical problems or conditions:
- Deep vein thrombosis
- Pulmonary embolism
- Unstable angina
- Prevention of post-operative deep venous thrombosis
Counselling For Side Effects:
Every medicine has some adverse effects so that heparin, so if you are suffering from any of the following symptoms after taking heparin consult your doctor or stop taking it:
- Thrombocytopenia (decrease in platelets) is main side effect f heparin. So platelets should be measured just before treatment with heparin and regular monitoring of platelet count is also recommended if given for longer than 4 days.
- Hyperkalemia (abnormally high level of potassium in the blood also occur.
- It can cause sudden numbness and weakness especially on one side of the body.
- Sudden severe headaches, confusion, problems with vision, speech or balance are also the side effects of heparin.
- Trouble breathing
- Extreme drowsiness
- Fever, chills
Counselling For Dose:
You should always take the recommended or prescribed dose. Do not alter the dose by yourself because it can be produce some adverse effects on the body.
Recommended doses for heparin are:
10,000U as initial dose followed by 8,000-20,000U to every 8-12 hours
10,000U as initial dose followed by 5,000-10,000U to every 6 hours
20,000-40,000U per day
- Intermittent IV:
- 50U/kg as initial dose followed by 100U/kg for every 4 hours.
- IV infusion:
- 50,000U/kg as initial dose followed by 20,000U/24 hours.
5,000U 2 hours before surgery and for 8-12 hours thereafter for 7 days.
Counselling For Administration:
For administration of heparin follow the instructions given below:
- Try to avoid the IM administration of heparin.
- Heparin can be administered subcutaneously and SC administration should be deep, usually prefer into fatty layer of abdomen.
- Always inject slowly.
- The IV administration of heparin given undiluted over 1 minute.
- It is inactive orally and must be administered parentally.
Counselling For Pregnancy:
Heparin has been assigned to pregnancy category C by FDA.
Heparin can be used for the management of venous thromboembolism in pregnancy because they do not cross the placenta.
Heparin preserved with benzyl alcohol should not be given to pregnant women because benzyl alcohol has been associated with some serious side effects and death especially in pediatrics.
Counselling For Food Interaction:
- Some drugs cause serious side effects when given with certain food or vegetables due to their interaction in body.
- In case of heparin vitamin K containing vegetables, fruits or meat should not be taken because vitamin K helps the blood to clot. Some of the vegetables, fruits, meat and other food which contain vitamin K are:
- Cabbage, cauliflower, spinach, soybeans, egg yolk, green apples, green tea leaves etc. so avoid these when you are taking heparin.
Counselling For Drug Interactions:
When some drugs are co-administered with other drugs they cause some serious problems. Similarly heparin should not be used with following drugs due to their interactions and possible problems:
These drugs increase the risk of bleeding when given with heparin.
Counselling For Contraindications:
If you are suffering from the following diseases then heparin is contraindicated in those medical conditions:
- Haemophillia(impaired body’s ability to control blood clotting)
- Hemorrhagic disorders
- Severe hypertension
- Severe liver damage
- Peptic ulcer
- Hypersensitivity to heparin
- Acute bacterial endocarditis (infection of inner surface of heart caused by bacteria)
Counselling For Precautions:
Heparin should be used with great precaution because it may cause the following side effects;
Generalized hypersensitivity can occur.
o Benzyl alcohol:
Benzyl alcohol used as preservative in some products is associated with a fatal gasping syndrome in premature infants.
o Elderly patient:
Higher incidence of bleeding in women>60 years>
o Renal impairment:
o Liver impairment:
Counselling For Storage:
It is necessary to store a drug properly. For example some drugs are sensitive to heat so do not put them near heat.
- Heparin should be store at room temperature which is.
- Protect the heparin from freezing.
- Inspect the drug for discoloration; note that slight discoloration does not alter potency.
- Heparin sodium
- Heparin calcium
- Tatro DS, Borgsdorf LR. A to z drug facts. Facts & Comparisons, 2003.
- Committee JF, Britain RPSoG. British National Formulary (BNF) 64. Pharmaceutical Press, 2012.
- Knoben JE, Anderson PO, Watanabe AS. Handbook of clinical drug data. Drug Intelligence Publications Hamilton, IL, 1988.
The team of medimoon.com would like to say special thanks to Miss Amna Amin (Pharm D) for her contribution in this article.
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