TRADE NAME : Heparin leo , heparin sodium GENERIC NAME : Heparin CLASSIFICATION: Anticoagulant

SC ONSET PEAK DURATION 20 ± 60 min. 1 ± 2 hrs 8-12 hrs 1- 2 h

IV Immediate

INDICATIONS

y y y

Prophylaxis for DVT and PE, tx of arterial embolism, pulmonary embolism, venous thrombosis Prevention of clotting during arterial/heart surgery Anticoagulant for use in blood transfusion and dialysis

CONTRAINDICATION

SIDE EFFECTS

COMMON ROUTES & DOSAGES NURSING CONSIDERATION/ INTERVENTIONS

y Hypersensitivity y Severe thrombocytopenia y Any uncontrolled bleeding Clinical consideration: Not intended for IM use. y CV ± hemorrhage CNS: Fever ,chills, headache y GU: Hematurea y Anaphylaxis y Local irritation at SC site Adult SC 10,000 ± 20,000 unit followed by 8000 ± 10, 000 unit tid IV 10,000 unit followed by 500 ± 10,000 unit 4-6 times /day Usual infusion dose 20,000 ± 40,000 unit/day y ASSESS: hx of hypersensitivity, elderly may require decrased dose y NDX: Tissue perfusion, ineffective. Trauma, risk for. y PLAN/IMPLEMENT: - Administer: By deep SC injection, intermittent IV injection, continuous IV infusion. - Avoid IM (danger of hematoma formation) - Can be mixed with dextrose, dextrose/NaCl, normal saline, invert sugar - Prepare fresh solutions; avoid storage for >24h - SC: use lower abdomen; change needle after preparation; don¶t aspirate; rotate sites; avoid massaging. - IV : use infusion pump; avoid mixing with other drugs in solution; have protamine sulphate available for OD y Monitor: Hepatic, CV, and renal status; signs of hemorrhage in abdominal and lumber pain - Treat with protamine sulphate (w/in 30m of heparin administration) y Patient Education: - report any bleeding/bruising immediately - Avoid smoking and alcohol - Use electric razor/depilatory for hair remobal - Avoid aspirin containing products - Check with physician/pharmacist before taking OTC preparations - Women: avoid breast feeding. y Evaluate: Improved blood flow

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