Heparin

Question 1

Main indication for heparin?

Answer 1

Anti-coagulant

Question 2

Mechanism of action for heparin?

Answer 2

Promotes antithrombin (immediate effect)

Two forms: unfractionated or low molecular weight heparin (LMWH)

Question 3

Contraindications and cautions of heparin?

Answer 3

Monitoring:

• Activated partial thromboplastin time for unfractionated.
• Anti-Xa assay for LMWH but usually no monitoring is required for LMWH as it has a more predictable response.

Question 4

Adverse effects of heparin?

Answer 4

• Bleeding
• Heparin-induced thrombocytopaenia (with thrombosis) HITT-monitor FBC in patients on heparin.
• Osteoporosis with long term use
• If reversal required:
  • Stop heparin
    *Occasionally in severe bleeding: protamine sulphate reverses antithrombin effect.

Question 5

Administration of heparin?

Answer 5

IV (intravenous) or SC (subcutaneous)