Heparins Flashcards
what are the two types of heparins
unfractionated heparin
LMWH heparin
how does heparin work
potentiates antithrombin
how does LMWH work
binds and forms a complex that mostly inhibits factor 10a
how does unfractionated heparin work
binds and forms a complex that mostly inhibits thrombin and factor 10a
what is antithrombin and what does it do
a naturally occuring anticoagulant which INHIBITS factor 10a and thrombin
how do you give unfractionated heparin
IV
how do you give LMWH
subcut
what are four indications for LMWH
PE
DVT
ACS
thromboprophylaxis
when would you use unfractionated heparin instead of LMWH in thromboprophylaxis
in renal impairment eGF <30
which type of heparin can be reversed
unfractionated
what monitoring is required for both types of heparin
Unfractionated: APTT every 6 hours
LMWH: none required
what are some side effects of heparin
bleeding
heparin induced thrombocytopenia
osteoporosis in prolonged use
if a patient bleeds whilst on LMWH what should you do
withold next dose
consider protamine sulphate
if a patient bleeds whilst on unfractionated heparin what should you do
stop infusion
give protamine sulphate
what reverses the effect of unfractionated heparin
protamine sulphate
