Heparin review

Heparin (Na) and Heparin (Cl) are injectible coagulants. They are highly sulfated glycosaminoglycan, and these molecules have the highest negative charge density. Pharmaceutical grade heparin (Na and Cl) is obtained from mucosal tissues of pork intestine and bovine lung.

Heparin Sodium, and heparin calcium injections are indicated primarily for anticoagulant therapy in the prophylaxis and treatment of venous thrombosis. Heparin may also be used as a low-dosage treatment in the prevention of deep vein thrombosis in patients who will undergo abdominothoracic surgery. It is also used to treat pulmonary embolism. Atrial fibrillation coupled with embolization is also part of the indication for the use of heparin.

Heparin is also used to diagnose and treat acute and chronic coagulopathies. It may also be used to prevent clotting during arterial and cardiac surgeries. Heparin is also used in the prophylaxis and treatment of patients with peripheral arterial embolism. It may also be used as an anticoagulant in blood transfusions.

Heparin Na and Heparin Cl come as an injectible drug, available in formulations of 2500 IU/ml, 5000 IU/ml and 25000 IU/ml.

The initial recommended dosage for adult patients for the treatment of deep vein thrombosis is at 5000 IU, given at a single dose. A single dose of around 15 – 20 IU is recommended as a follow-up dose after the initial injection.

For the prophylaxis of deep vein thrombosis, 5000 Iu of heparin is required, which is to be given every 8 hours.

The recommended pediatric dose is at 500 IU given over a 24-hour period. For neonatal patients, the recommended dosage is set at 75 IU to be given as it is recommended.

Allergic reactions such as hives, swelling of the face, mouth, lips, and pain at the injection sites are some of the commonly reported side effects of the use of heparin.

However, the use of heparin may yield to severe and potentially life threatening effects such as thrombocytopenia, and bleeding, which may lead to further complications such as skin necrosis, hypoaldosteronism and osteoporosis.

Nausea, vomiting, and gastrointestinal pain (including diarrhea and bloatedness) may also be some of the drug’s side effects. If not given attention, the use of the drug may lead to abdominal bleeding, or ulcers.

Other less threatening, yet serious side effects of the use of heparin include urticaria, conjunctivitis, rhinitis, cyanosis, anaphylactic shock asthma, even mood and mental changes such as feelings of depression, oppression.

Heparin is discovered to be contraindicated in patients with a known hypersensitivity to the drug or its known components, and to other anticoagulants. It is also contraindicated in patients with suarachnoid hemorrhage, hemostatic defects, liver and kidney failure, arterial thrombosis, abdominal bleeding, and cerebral hemorrhage.

Heparin has been found to have drug interactions with platelet inhibitors. Medications such as dextran, phenylbutazone, ibuprofen, acetylsalicylic acid and others that may interfere with platelet aggregation may induce bleeding, and thus should be used in caution when receiving heparin treatment.

Tetracyclines, antihistamines, and narcotics may somehow counteract the anticoagulant effects of heparin. The careful monitoring of patients and dosage adjustment for heparin may be needed when there is concomitant use of such drugs.

The use of heparin on geriatric patients must be given caution, especially for women over 60 and for those with known kidney or liver impairment.

It is not known whether heparin has adverse effects to the fetus. However, the use of the drug in pregnant women should always be consulted with the doctor. Nursing mothers, or women planning to breastfeed must first consult their doctor prior to the usage of the drug. The potential benefits of the drug must always be weighed against its risks to the nursing mother and infant.

Heparin has the following structural formula:

Chemical structure of heparin

• Chemical IUPAC Name is (C26H40N2O36S5)n

Brand name(s): Alpha-Heparin, Ariven, Arteven, Bemiparin, Calcilean, Calciparine, Certoparin, Clexane, Clivarin, Clivarine, Dalteparin, Depo-Heparin, Enoxaparin, Eparina, Fluxum, Fragmin A, Fragmin B, Fraxiparin, Hed-Heparin, Hepalean, Heparinate, Heparinic acid, Hepathrom, Leparan, Lipo-Hepin, Liquaemin, Liquemin, Multiparin, Novoheparin, Pabyrin, Parnaparin, Parvoparin, Pularin, Reviparin, Sandoparin, Sodium heparin, Sublingula, Thromboliquine, Vetren, Vitrum AB

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