Heparin Drug Study

In making a Drug Study, the following elements must be present: Generic Name and the Brand name (not all brands, just the brand used by the patient), Action, Indication, Pregnancy Category, Drug Classification, and Contraindication, Adverse Effect, Drug interaction and Nursing Consideration/Intervention…. Most clinical instructors preferred this to be in a long bond paper in printed or handwritten with paper in landscape.

Heparin

Brand Name: heparin sodium injection, Hepalean (CAN), Heparin Leo (CAN)

Pregnancy Category C

Drug class: Anticoagulant,

Therapeutic actions

Inhibits thrombus and clot formation by blocking the conversion of prothrombin to thrombin and fibrinogen to fibrin, the final steps in the clotting process.

Indications

· Prevention and treatment of venous thrombosis and pulmonary embolism

· Treatment of atrial fibrillation with embolization

· Diagnosis and treatment of DIC

· Prevention of clotting in blood samples and heparin lock sets and during dialysis procedures

· Unlabeled uses: adjunct in therapy of coronary occlusion with acute MI, prevention of left ventricular thrombi and CVA post-MI, prevention of cerebral thrombosis in the evolving stroke

Contraindications

· Hypersensitivity to heparin; severe thrombocytopenia; uncontrolled bleeding; any patient who cannot be monitored regularly with blood coagulation tests; labor and immediate postpartum period; women older than 60 yr are at high risk for hemorrhaging; dysbetalipoproteinemia; recent surgery or injury.

Adverse effects

Loss of hair

Hemorrhage; bruising; thrombocytopenia; elevated AST, ALT levels, hyperkalemia

Chills, fever, urticaria, asthma

Osteoporosis, suppression of renal function (long-term, high-dose therapy)

Drug Interactions:

· Increased bleeding tendencies with oral anticoagulants, salicylates, penicillins, cephalosporins

· Decreased anticoagulation effects if taken concurrently with nitroglycerin

Nursing considerations

· Adjust dose according to coagulation test results performed just before injection (30 min before each intermittent dose or q 4 hr if continuous IV dose). Therapeutic range APTT: 1.5–2.5 times control.

· Use heparin lock needle to avoid repeated injections.

· Give deep SC injections; do not give heparin by IM injection.

· Do not give IM injections to patients on heparin therapy (heparin predisposes to hematoma formation).

· Apply pressure to all injection sites after needle is withdrawn; inspect injection sites for signs of hematoma; do not massage injection sites.

· Mix well when adding heparin to IV infusion.

· Do not add heparin to infusion lines of other drugs, and do not piggyback other drugs into heparin line. If this must be done, ensure drug compatibility.

· Provide for safety measures (electric razor, soft toothbrush) to prevent injury from bleeding.

· Check for signs of bleeding; monitor blood tests.

· Alert all health care providers of heparin use.

· Have protamine sulfate (heparin antidote) on standby in case of overdose; each mg neutralizes 100 units of heparin.