Heparin (Liquaemin)

Category:

  • Miscellaneous

Description:

  • Anticoagulant

Indications:

  • Venous thrombosis, pulmonary embolism, peripheral arterial embolism

  • Coagulopathies, DVT/PE prophylaxis, clotting prevention in arterial and heart surgery

  • Blood transfusions, extracorporeal circulation, dialysis and blood samples

Contraindications:

  • Severe thrombocytopenia, uncontrolled bleeding (except when due to DIC)

  • Suspected intracrainial hemorrhage, shock, severe hypotension

Precautions:

  • Pregnancy category C; does not cross placental barrier; not excreted in breast milk

  • IM injection (avoid due to risk for hematoma)

  • Elderly, children, diabetes,  renal insufficiency, severe hypertension

  • Subacute bacterial endocarditis, acute nephritis, peptic ulcer disease, sever renal disease

Adverse Reactions (Side Effects):

  • CNS: fever, rash

  • CV: allergic vasospastic reactions, shock

  • EENT: lacrimation, rhinitis

  • GI: nausea, vomiting

  • GU: hematuria, priapism

  • HEME: hemorrhage, thrombocytopenia, white clot syndrome

  • RESP: anaphylactoid reactions, asthma

  • SKIN: chills, cutaneous necrosis, delayed transient alopecia, erythema, histamine-like reactions, local irritation, urticaria

Dosage:

Administered SC and IV

  • Adult:            

    • DVT/PE: 

      • IV INF 50-100 u/kg initially, then 15-25 u/kg/hr, adjusted based on APTT results; intermittent IV 10,000u initially, then 75-125 u/kg every 4-6 hours

      • SC 10,000-20,000u initially, then 8,000-10,000u every 8 hours or 15,000-20,000u every 12 hours

    • Prevent DVT/PE: 

      • SC 5000u every 8-12 hours until patient is ambulatory

  • Child:   

    • IV INF 50 u/kg initially, then 15-25 u/kg/hr, increase dose by 2-4 u/kg/hr every 6-8 hours based on aPTT results

    • Intermittent IV 50-100 u/kg initially, then 50-100 u/kg every 4 hours

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