MEDICATION

Name:

Medication Name: Heparin

Drug Classification: Therapeutic: anticoagulants

Pharmacological: antithrombotic

Indication for Patient: It is used prophylactically and as a treatment for various thromboembolic
disorders including: deep vein thrombosis, peripheral arterial thromboembolism, atrial
fibrillation with embolization, and acute/chronic consumptive coagulopathies. It can also be used
in very low doses to maintain patency of IV catheters.

Action/Therapeutic Use: It increases the effect of the inhibitory effect of antithrombin on factor
Xa and thrombin. In low doses, it prevents the conversion of prothrombin to thrombin by its
effects on factor Xa. In higher doses, it neutralizes thrombin to prevent the conversion of
fibrinogen to fibrin.

Contraindications/Precautions: Contraindicated in: Hypersensitivity, uncontrolled bleeding,

severe thrombocytopenia, open wounds, benzyl alcohol in premature infants. Use Cautiously in:
Severe liver or kidney disease, retinopathy, untreated hypertension, ulcer disease, spinal cord or
brain injury, history of congenital or acquired bleeding disorder, malignancy, women older than
60 years old. Exercise Extreme Caution in: Severe uncontrolled hypertension, bacterial
endocarditis, bleeding disorders, GI bleeding, hemorrhagic stroke, recent CNS or ophthalmologic
surgery, history of thrombocytopenia related to heparin.

Adverse Reactions/Side Effects: drug-induced hepatitis, alopecia, rashes, urticaria, anemia,

bleeding, thrombocytopenia, pain at injection site, osteoporosis, fever, hypersensitivity

Interactions: Drug-Drug: Aspirin, NSAIDs, Clopidogrel, Dipyridamole, Penicillins, Abciximab,

Eptifibatide, Tirofiban, Dextran, Quinidine, Cefotetan, Valproic Acid, Thrombolytics (increased
risk for bleeding), Warfarin (affects the prothrombin time used in assessing the response),
Digoxin, Tetracyclines, Nicotine, Antihistamines (decreased anticoagulant effect), Streptokinase
(resistance to Heparin). Drug-Natural Products: Garlic, ginger, ginseng, clove (increased risk of
bleeding).

Nursing Implications (Assessments/Labs Considerations): Assess for signs of bleeding and

hemorrhage and notify HCP if they occur, assess patient for evidence of additional or increased
thrombosis, monitor patient for hypersensitivity reactions, observe injection sites for hematomas,
ecchymosis, and inflammation, monitor activated partial thromboplastin time and hematocrit
prior to and periodically during therapy, IV therapy-- draw aPTT levels 30 min before each dose
during initial therapy and then periodically, SQ therapy-- draw blood 4–6 hrs. after injection,
monitor platelet count every 2–3 days throughout therapy, monitor AST and ALT levels.

Client Education: Teach patient to take medication as ordered, advise patient to report any
symptoms of unusual bleeding or bruising to HCP immediately, instruct patient not to take
medications containing aspirin or NSAIDs while on heparin therapy, advise patients to use a soft
toothbrush and be cautious when using an electric razor during heparin therapy, teach patient to
inform HCP of medication regimen prior to treatment or surgery, patients on anticoagulant
therapy should carry an identification card with this information at all times.

Textbook Reference: (Pharmacology: Connections to Nursing Practice, 3rd edition pg. 616-620)
-Adams, M., & 1951-. (2010). Pharmacology: connections to nursing practice. Upper Saddle
River, NJ: Pearson Prentice Hall.

(Davis’s Drug Guide for Nurses; Sixteenth Edition; pages 635-638)

- Vallerand, A. H., Sanoski, C. A., & Quiring, C. (2019). Davis’s Drug Guide for Nurses.
Philadelphia, PA: F.A. Davis Company.

Please include the title of the text, edition, and page number(s) you referenced.
Your ATI Book will NOT be accepted as a reference.