2. Whats Heparin:
Heparin is an anticoagulant (blood thinner)
that prevents the formation of blood clots.
Heparin is used to treat and prevent blood
clots in the veins, arteries, or lung. Heparin is
also used before surgery to reduce the risk of
blood clots
3. Heparin – the molecule
heparin is heterogeneous of un branched
polysaccharide chains
Alternating monosaccaride units of
L-iduronic acid and D-glucosamine
one third of the polysaccharide chain
contain a specific antithrombin binding
pentasaccharide sequence
4. Heparin – the source
preparation from porcine and bovine
intestinal mucous
- preparation from bovine lung
5. Mechanism of action :
Heparin exerts parts of its anticoagulant activity
through interaction with antithrombin
antithrombin binds specifically to a
pentsaccharide in heparin
binding to heparin induced a conformational
change in the antithrombin , which accelerate
enzyme inhibition
6.
7. Forms of heparin :
1- unfractionated heparin (UF)
2- low molecular weight heparin (LMW)
8. Trade Names
. Heparin Sodium
. Heparin I.V. Flush
. Monoject PreFill Advanced (this form of heparin must not
be used to treat or prevent blood clotting in the body )
9. Pharmacokinetics:
Absorption: Heparin is not absorbed from GI; must
be given IV or subcutaneously,
Metabolism: The liver andreticuloendothelial
system are the sites of biotransformation.
Elimination: The average half-life is 1.5 h
(range, 1 to 6 h) and is dose dependent Excreted in the
urine
10. Indications and Usage:
- Prophylaxis and treatment of venous thrombosis and
it extensions
- pulmonary embolism (PE), peripheral arterial
embolism, and atrial fibrillation with embolization.
- treatment of acute and chronic consumption
coagulopathies (disseminated intravascular coagulation
[DIC])
11. - prevention of postoperative deep venous thrombosis
- Also used to maintain catheter patency and as an
anticoagulant in blood transfusions, extracorporeal
circulation, dialysis, and laboratory samples.
12. Dosage and Administration:
- intravenously (immediate effect)
- 20 to 40 thousands units/day dose
- subcutaneously ( effect on 20-60 min )
-8,000 to 10,000 units every 8 h .
13.
14. Contraindications :
- Severe thrombocytopenia
- Patients in whom suitable blood coagulation tests
cannot be performed.
- Hypersensitivity to heparin or any other product
ingredients.
15. - do not administer products containing benzyl alcohol
as a perseverative to neonates, infants, pregnant
women, or breast-feeding women
- Patients with hypersensitivity to corn products and
bisulfites (may be contained in some heparin sodium
in dextrose 5%
17. Adverse Reactions
-Hematologic:Hematologic side effects including
hemorrhage at any site have been reported the most frequently.
-Cardiovascular:Cardiovascular side effects have
included new or recurrent arterial and venous thrombosis in
association with thrombocytopenia.
-Dermatologic:Dermatologic side effects have included
extensive skin necrosis, necrotic lesions at subcutaneous injection
sites
18. -Musculoskeletal : Musculoskeletal side effects have
included osteoporosis
-Endocrine: Endocrine side effects have included increased
free thyroxine levels. Acute adrenal insufficiency caused by heparin
induced adrenal hemorrhage has been reported
