Bluehep

Treatment & prophylaxis of thromboembolic disorders, VTE (DVT & pulmonary embolism), especially prophylaxis in surgical patients & in those pregnant women at particular risk. Used for the management of arterial thromboembolism including that associated w/ unstable angina pectoris, MI, acute peripheral arterial occlusion & stroke. Treatment of disseminated intravascular coagulation. Prevent coagulation during hemodialysis & other extracorporeal circulatory procedures eg, cardiopulmonary bypass.

IV/SC VTE Loading dose: 5,000 u (10,000 u may be required in severe pulmonary embolism) followed by continuous IV infusion of 1,000-2,000 u/hr or SC inj of 15,000 u every 12 hr. Alternatively, intermittent IV inj of 5,000-10,000 u every 4-6 hr. Prophylaxis of post-op VTE 5,000 u SC inj 2 hr before surgery then every 8-12 hr for 7 days or until the patient is ambulant. Prevention of re-occlusion of the coronary arteries following thrombolytic therapy in MI 5,000 u IV followed by 1,000 u/hr IV w/ alteplase. Prevention of mural thrombosis 12,500 u SC every 12 hr for at least 10 days. Childn & small adult Lower IV loading dose followed by maintenance w/ continuous IV infusion of 15-25 u/kg/hr or SC inj of 250 u/kg every 12 hr. Pregnant woman (3rd trimester) w/ history of DVT or pulmonary embolism Dose may be increased to 10,000 u every 12 hr.

Hypersensitivity. Patients w/ generalized clotting disorder eg, hemophilia, Christmas disease, ITP & patients w/ active bleeding from a local lesion (eg, acute ulcer or ulcerating carcinoma); patients who have had recent cranial, spinal, eye or ear surgery or trauma. Thrombocytopenia, severe liver damage, shock.

Administration of large doses of heparin Na inj should be delayed 4 hr post-op. Subacute bacterial endocarditis, increased capillary permeability, dissecting aneurysm, severe HTN, during & immediately following major surgery especially of the brain, spinal cord, eye or ear; conditions associated w/ increased bleeding tendencies (eg, hemophilia, thrombocytopenia & some purpuras), inaccessible GI ulcers, ulcerative colitis, continuous tube drainage of stomach or small intestine; threatened abortion; menstruation; malignant HTN. Immediate post-op period. Consider appropriate alternatives in patients w/ history of heparin-induced thrombocytopenia, heparinoids (eg, danaparoid), lepirudin, & ancrod. Can prolong the prothrombin time. Apparent resistance to heparin may be encountered in patients w/ acquired or familial AT III deficiency. Larger doses may be required initially in patients w/ febrile illness, infections associated w/ thrombosing tendencies, pulmonary embolism, MI, extensive thrombotic disorders especially those associated w/ neoplastic disease & following surgery. Avoid IM inj of other drugs during therapy to reduce the risk of hematoma formation & bleeding from the site. Regulate by frequent blood coagulation indicators particularly APTT when used in therapeutic doses. Observe for possible development of osteoporosis & spontaneous of ribs &/or vertebrae in patients on long-term daily administration. Severe hepatic or renal disease, or in patients w/ indwelling catheters. Pregnancy.

Osteoporosis & spontaneous vertebral fractures in longer administration >3 mth. Bleeding; thrombocytopenia, heparin-induced thrombocytopenia; hypersensitivity, asthma, rhinitis, tearing, headache, nausea, vomiting, shock & anaphylactoid reactions; vasospasm; alopecia; itching & burning of the plantar surfaces of the feet, suppression of aldosterone product, hyperkalemia; priapism, & rebound hyperlipidemia.

Increase in APTT w/ oral anticoagulants (ie, warfarin). Increased risk of bleeding w/ salicylates, other NSAIDs, dextran, dipyridamole, clopidogrel, ticlopidine, & GPIIb-IIIa antagonists. May cause GI bleeding w/ IV ethacrynic acid. Avoid concurrent use w/ ASA. Concomitant use w/ dextran.

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

B01AB01 - heparin ; Belongs to the class of heparin group. Used in the treatment of thrombosis.

Rx