Venous Thromboembolism Unfractionated Heparin - recorded lecture

Question 1

Unfractionated Heparin
characteristics, monitoring, dosing, and adverse effects

Answer 1

1. Rapid, parenteral anticoagulant (IV)
2. aPPT (activated partial thromboplastic time) monitoring needed (GOAL : 1.5-2.5 time control)
3. weight based dosing ( 80units/kg IV bolus) (18units/kg/hr)
4. Adverse effects: Bleeding and Thrombocytopenia

Question 2

What is Heparin Associated Thrombocytopenia (HAT)?

Answer 2

• also known as HIT-Type 1
• non-immune mediated
• Mild decrease in platelets
  Occurs around 48-72 hours after administrating heparin
• Transient (doesn’t last too long)
• Do not need to discontinue heparin

Question 3

What is Heparin induced thromobocytopenia (HIT)?

Answer 3

immune medicated
thrombotic complications
Occurs between: 7-14 days
Can occur up to 9 days after stopping therapy
- Platelets drop more than 50% from baseline (<100,000/mm^3)

Question 4

HIT management

Answer 4

-Stop all heparin production and give alternative
- anticoagulant (lepirudin, or argatroban, etc.)
- Do not give platelet infusions
- Do not give warfarin until platelet count > 150,00
- evaluate for thrombosis