Notes

GENERIC NAME: HEPARIN SODIUM AND SODIUM CHLORIDE
TRADE NAME: Heparin sodium and 0.45% Sodium Chloride, Heparin Sodium and 0.9%Sodium Chloride
CLASSIFICATION: Heparin, Anticoagulant
ACTION: Does not dissolve previously formed clots, but forestalls enlargement and preventsnew clots from forming; Potentiates inhibitory action of antithrombin III; Occurs due toformation of a complex with antithrombin III and causing a conformational change inantithrombin III molecule; Action of thrombin in coagulation is inhibited; Also preventsformation of a stable fibrin clot by inhibiting the activation of fibrin-stabilizing factor bythrombin
INDICATIONS: Pulmonary/peripheral arterial embolism; Prophylaxis and treatment of venousthrombosis and extensions; Atrial fibrillation with embolization; Treatment and diagnosis of DIC;in low doses to prevent DVT and PE in pregnant clients with thromboembolism history andothers; Prophylaxis of clotting in blood transfusions and others
ROUTES OF ADMINISTRATION: Deep Subcutaneous, Intermittent IV, Continuous IV,Special Uses
USUAL DOSAGE: Deep SC: Initial loading dose 10,000-20,000 units; maintenance dose 8,000-10,000 units q 8 hr or 15,000-20,000 units q 12 hr: IV Inter: ILD-10,000 units undiluted or in 50-100mL saline, then 5,000-10,000 units q 4-6 hr undiluted or in 50-100mL saline: Cont IV: ILD-20,000-40,000 units/day in 1,000mL saline after 5,000 units IV
ADVERSE REACTIONS
: Hemorrhage ranging from minor local ecchymoses to major hemorrhagic complications from any organ, chills, fever, urticaria, local irritation,erythema, mild pain, hematoma
INTERACTIONS:Oralanticoagulants/dipyridamole/hydroxychloroquine/ibuprofen/indomethacin/NSAIDs/ticlopidine – additive ↑ prothrombin time;Antihistamines/digitalis/nicotine/nitroglycerin/tetracyclines - ↓ effect of heparin
CONTRAINDICATIONS: Active bleeding, blood dyscrasias (or other bleedingdisorders as in hemophilia), clients with frail or weakened blood vessels,purpura,thrombocytopenia, liver disease with hypoprothrombinemia, open wounds, extensivedenudation of skin, increased capillary permeability; do not administer during surgery of eye, brain or spinal cord or during continuous tube drainage of stomach or small intestine
NURSING CONSIDERATIONS: Do not administer IM; administer by deep subQinjection to minimize local irritation, hematoma, and tissue sloughing and to prolong drugaction; utilize Z-track method or ‘Bunch technique’ method; do not administer within 2in of umbilicus (decreased vascularity); do not massage site, slight discoloration does notaffect potency; perform test dose (1,000 units subQ) on clients with allergies or asthma history