Heparin is a medication given as a subcutaneous injection and available with a doctor's prescription. It belongs to the class of drugs called anticoagulants and is used to treat and prevent blood clots in the deep veins in the body. Heparin may not be for everyone and caution should be used in certain patients.
Warnings
Heparin may cause hypersensitivity reactions that are characterized by chills, fever and itchiness. Rarely, shortness of breath, nausea, vomiting and shock may also occur. Patients who have developed a hypersensitivity reaction to heparin in the past should use the medication with caution and only in life-threatening reactions, explains the "Drug Information Handbook." Caution should be used in patients with high blood pressure and diabetic neuropathy. Certain patients are at increased risk of bleeding and should be prescribed the drug with caution. Risk factors include an infection called bacterial endocarditis, bleeding disorders, active stomach ulcer, and following brain, spinal or eye surgery. Thrombocytopenia, which is a disorder that impairs clotting, may occur and requires discontinuation of the drug.
Contraindications
Heparin is contraindicated in patients who have active bleeding or hemophilia, which is a group of bleeding disorders in which the blood takes a long time to clot, states "Basic and Clinical Pharmacology." Patients with intracranial hemorrhage should not be given this drug. Heparin should be administered intramuscularly because it causes severe local site reactions, including bruising, pain, irritation and swelling. The medication is also contraindicated in advanced kidney and liver failure.
Monitoring
Monitoring parameters include platelet counts, hemoglobin, hematocrit and signs of bleeding. Activated partial thromboplastin time, or APTT, should also be measured regularly. APTT measures the efficacy of the coagulation pathway. The patient should keep all doctor appointments to ensure proper monitoring and safety.
Overdose
The main symptom of overdose is bleeding, states the "Drug Information Handbook." If the patient develops bruises easily on the skin, or notices his gums bleeding, this may indicate an overdose. Blood in the stool, which appears brown-black in color, and blood in the urine, which appears red-brown in color, indicates bleeding from the stomach and/or intestines. If the patient experiences any of these signs, he should seek immediate medical help.
Drug Interactions
Medications that thin the blood should not be given with heparin because they may increase the risk of bleeding out, according to "Pharmacotherapy: A Pathophysiologic Approach." These medications include aspirin, warfarin, argatroban, nonsteroidal anti-inflammatory drugs, clopidogrel, tetracycline, quinine, digoxin and nicotine. The patient should inform her physician of the medications she uses.
References
- "Drug Information Handbook"; Charles F. Lacy, Lora L. Armstrong, et al.; 2009
- "Basic and Clinical Pharmacology"; Bertram G. Katzung; 2007
- "Pharmacotherapy: A Pathophysiologic Approach"; Josep T. Dipiro, Robert L. Talbert, et al.; 2008
