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Heparin, also known as unfractionated heparin (UFH), is a medication and naturally occurring glycosaminoglycan. [3] [4] Heparin is a blood anticoagulant that increases the activity of antithrombin. [5] It is used in the treatment of heart attacks and unstable angina. [3] It can be given intravenously or by injection under the skin. [3]
Heparin is a naturally occurring glycosaminoglycan. There are three major categories of heparin: unfractionated heparin (UFH), low molecular weight heparin (LMWH), and ultra-low-molecular weight heparin (ULMWH). [83] Unfractionated heparin is usually derived from pig intestines and bovine lungs. [84]
Apart from using unfractionated heparin instead, it may be possible to reduce the dose and/or monitor the anti-Xa activity to guide treatment. [ 3 ] The most common side effects include bleeding, which could be severe or even fatal, allergic reactions, injection site reactions, and increases in liver enzyme tests, usually without symptoms. [ 13 ]
[12] [11] It is on the World Health Organization's List of Essential Medicines. [13] Enoxaparin is sold under several brand names and is available as a generic medication. [11] Enoxaparin is made from heparin. [12] In 2020, it was the 350th most commonly prescribed medication in the United States, with more than 500 thousand prescriptions. [14]
HIT is a very serious adverse event related to heparin and occurs with both unfractionated heparin and LMWH, although to a lesser extent with the latter. It is an immune-mediated, prothrombotic complication which results from a platelet-activating immune response triggered by the interaction of heparin with platelet factor 4 (PF4). [16]
Heparin may be used for both prevention and the treatment of thrombosis. It exists in two main forms: an "unfractionated" form that can be injected under the skin (subcutaneously) or through an intravenous infusion, and a "low molecular weight" form that is generally given
The most commonly used anticoagulants in clinical practice, warfarin and the heparin series of anticoagulants and fondaparinux, act to inhibit the action of Factor Xa in various degrees. Traditional models of coagulation developed in the 1960s envisaged two separate cascades, the extrinsic (tissue factor (TF)) pathway and the intrinsic pathway.
Dalteparin is not superior to unfractionated heparin in preventing blood clots. [5] Heparins are cleared by the kidneys, but studies have shown that dalteparin does not accumulate even if kidney function is reduced. [6] Approximately 70% of dalteparin is excreted through kidneys based on animal studies. [7]