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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]
As they are administered by injection (intravenous, intramuscular or subcutaneous), they are less suitable for long-term treatment. [ 1 ] Argatroban (as well as the hirudins) is used for heparin-induced thrombocytopenia , a relatively infrequent yet serious complication of heparin treatment that requires anticoagulation (as it increases both ...
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]
Guidelines from professional societies recommend treatment with alternative anticoagulants instead of heparin, as there is a possibility that it may aggravate the phenomenon. [34] [35] Alternative options as the directly acting oral anticoagulants (DOACs), argatroban, fondaparinux or danaparoid depending on the circumstances. [34]
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 subcutaneously.
It is thought that much protein interaction with heparin is not direct, and instead heparin binding protein actually interact with glycosaminoglycan (GAG) side chains or mucins bound to the heparin polymer, so it is possible that heparinoids interact with these proteins in a similar way, acquiring GAG side chains in vivo.
Once the Heparin therapy is initiated, the patient's PTT (partial thromboplastin time) levels will be monitored closely per hospital protocol to prevent excessive anti-coagulation. If a patient is allergic to Heparin or has a condition known as Heparin-induced Thrombocytopenia (HIT), an alternative intravenous anti-coagulate may be used.
Protamine sulfate is a medication that is used to reverse the effects of heparin. [3] It is specifically used in heparin overdose, in low molecular weight heparin overdose, and to reverse the effects of heparin during delivery and heart surgery. [3] [4] It is given by injection into a vein. [3] The onset of effects is typically within five ...