Heparin Flashcards
Therapeutic Classification:
Anticoagulant
Pharmacological Classification
Indirect Thrombin inhibitor
Pregnancy Category
C
o Cannot be given orally, does not cross placenta or into breast milk
o Protein bound therefore levels can vary
Administration
• Administered by injection only: IV-cont or intermittent, Deep SubQ
• Mechanism of Action
Activates antithrombin III, which inhibits thrombin and to lesser extent factor Xa.
o Antidote – protamine sulfate
• Indications:
o Acute thromboembolic disorders o DVT o Pulmonary embolism o Unstable angina o Evolving MI o Prophylaxis
• Precautions:
o Peripartum patients
o Serious renal or hepatic impairment
• Contraindictions:
o Active internal bleeding o Serious bleeding pathologies o Severe HTN o Recent trauma o Intracranial hemorrhage o Bacterial endocarditis o Sulfite sensitivity o Severe thrombocytopenia
• Drug Interactions
o Potentiated effect with oral anticoagulants
o Bleeding with drugs that inhibit platelet aggregation
o Inhibited anticoagulation with nicotine, digoxin, tetracyclines, antihistamines
o Ginger, garlic, green tea, feverfew, ginkgo
• Adverse Effects
o Mild allergic symptoms
o Osteoporosis
o Skin lesions
• Serious adverse effects
o Abnormal bleeding o HIT (Heparin Induced thrombocytopenia)
• Nursing Responsibilities
o Complete Health History
o Baseline blood tests
o Monitor aPTT
o Collect blood for testing 30 minutes prior to dose
o Monitor for signs of bleeding
o Apply firm pressure x10 min for needle stick
o Reduce risk of trauma
o Keep heparin antidote readily available
• Patient/Family Teaching
o Avoid activities that may result in injury
o Immediately report bleeding problems
o Menstruation may be increased
o Avoid smoking and alcohol
o Do not take other drugs or supplements
o Learn subcutaneous injection techniques
o Inform dentist prior to procedures
