What Are the Heparin Protocols?
Heparin sodium can interfere with many aspects of the blood coagulation process, and has anticoagulant effects in and outside the body. Its mechanism of action is more complex, mainly by combining with antithrombin III (AT-III), and enhancing the latter's inhibitory effect on activated II, , X, , and coagulation factors, the consequences of which involve preventing platelet aggregation and It destroys and prevents the formation of coagulation-activating enzymes, prevents thrombin from becoming thrombin, and inhibits thrombin, thereby preventing fibrinogen from becoming fibrin, thereby exerting an anticoagulant effect.
Basic Information
- Chinese name
- Heparin sodium
- English name
- Heparin sodium
- nickname
- Dalparin sodium; Enoxaparin sodium; Heparin sodium salt; Tinzaparin sodium
- Chemical formula
- ca. (C12H16NS2Na3) 20
- Molecular weight
- ca. 12000
- CAS Registry Number
- 9041-08-1; 101921-26-0; 102785-31-9; 12656-11-0
Heparin sodium indication
- 1. Prevention of thrombosis and embolism, such as deep venous thrombosis, myocardial infarction, pulmonary embolism, thrombophlebitis, and postoperative thrombosis.
- 2. Treatment of diffuse intravascular coagulation (DIC) caused by various reasons, such as DIC caused by bacterial sepsis, early detachment of placenta, and lysis of malignant tumor cells, except for DIC caused by snake bites. Early application can prevent the consumption of fibrinogen and other coagulation factors.
- 3. Other anticoagulants in vivo and in vitro, such as cardiac catheterization, cardiopulmonary bypass, hemodialysis, etc.
Clinical application of heparin sodium
- Intravenous or intramuscular injection: 0.5 to 10,000 units / time, once every 4 to 12 hours. Intravenous drip: Add 5% dextrose in water or normal saline every 24 to 20,000 units, and 20 to 50 drops per minute.
Heparin sodium adverse reactions
- 1. The most common type of bleeding may occur anywhere.
- 2. Common chills, fever, urticaria and other allergic reactions.
- 3. Long-term medication can cause hair loss and transient reversible alopecia, osteoporosis and spontaneous fracture.
- 4. Local injections show local irritation, erythema, slight headache, hematoma, ulcers, etc. It is more serious after intramuscular injection, so intramuscular injection is not suitable.
- 5. Transient thrombocytopenia is also seen. Heparin-induced thrombocytopenia (HIT) is caused by the binding of the heparin-platelet factor 4 antibody complex to the platelet factor 4 receptor. Can activate platelet aggregation, causing arterial embolism. Although rare, it can be fatal. If HIT occurs, heparin should be stopped immediately.
Heparin sodium precautions
- The clotting time should be measured regularly during the medication. Elderly people over 60 years of age are more sensitive to this product. They should reduce the dosage and strengthen monitoring. This product can only be used by pregnant women when they have a clear indication. This product does not secrete into milk. Intramuscular or subcutaneous injection is more irritating, and a fine needle should be used for deep intramuscular or subcutaneous fat tissue injection.
Contraindication to heparin sodium
- People who are allergic to heparin, have bleeding tendency and coagulation mechanism disorders (such as hemophilia, purpura, thrombocytopenia), peptic ulcer, trauma, threatened abortion and postpartum hemorrhage, severe hypertension, intracranial hemorrhage, bacterial endocarditis , Active tuberculosis, visceral tumors, severe liver and kidney dysfunction, patients with trauma and surgery are disabled.
Heparin sodium drug interactions
- 1. Heparin in combination with the following drugs can aggravate the risk of bleeding: coumarin and its derivatives, aspirin and non-steroidal anti-inflammatory analgesics, dipyridamole, dextran, adrenal corticosteroids, adrenocorticotropic hormones, tissue fibrinolysis Zymogen activator, urokinase, streptokinase, etc.
- 2. Heparin combined with sodium bicarbonate, sodium lactate and other drugs to correct acidosis can promote the anticoagulant effect of heparin.
- 3. Mixed injection of heparin and hyaluronidase can reduce muscle injection pain and promote heparin absorption. However, heparin can inhibit hyaluronidase activity, so the two should be used together temporarily, and should not be left for long after mixing.
- 4. Heparin can interact with insulin receptors, thereby changing the binding and effect of insulin.
- 5. Cannot be combined with alkaline drugs.
- Note: The above content is only for introduction, the drug use must be carried out by a regular hospital under the guidance of a doctor.