Heparin

Question 1

Drug class

Answer 1

Anticoagulant

Question 2

Pharmacology

Answer 2

Heparin combines with the anti-thrombin III to inhibit Factor X & the conversion of pro-thrombin to thrombin. Therefore, it reduces the propensity for new clot formation & also inhibits other processes in the clotting cascade.

Question 3

Metabolism

Answer 3

Metabolised via biotransformation in the liver & reticulo-endothelial system. Metabolites are then excreted in the urine

Question 4

Indications

Answer 4

Pts with STEMI (as per CARC) who have been accepted for pPCI (as an adjunct medication to aspirin AND EITHER ticagrelor OR clopidogrel)

Question 5

Contraindications

Answer 5

Absolute contras:
• allergy and/or adverse drug reaction 
• pts <18yrs
• active bleed (excl. menses) OR clotting problem (haemophilia)
• Prior intracranial haemorrhage 
• Current use of anticoagulants 

Relative contras:
(Reqs consult with accepting cardiologist OR RSQ prior to adim)
• uncontrolled hypertension - systolic >180 OR diastolic >110 at any stage
• known cerebral disease i.e malignant intracranial neoplasm OR ateriovenous malformation
• ischaemia stroke or TIA within last 3 months
• Hx significant closed head / facial trauma within last 3 months
• Hx major trauma or surgery (inc. laser eye) within last 6 wks

Question 6

Precautions

Answer 6

Renal impairment

Question 7

Side effects

Answer 7

• Haemorrhage

* Thrombocytopenia

Question 8

Presentation

Answer 8

5,000 units/5ml amp

Question 9

Onset

Duration

Answer 9

IV
O ~30sec
D 3-6hrs

Question 10

Routes of administration

Answer 10

IV

Question 11

Adult dosages

Answer 11

STEMI

IV 5,000 units (or dose requested)
Single dose only