Hematology and Oncology Book

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Unfractionated HeparinAka: Heparin

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  1. See Also
    1. Low Molecular Weight Heparin
  2. Mechanism
    1. Potentiates Antithrombin III (AT III)
    2. See Intrinsic Clotting Pathway
  3. Dosing: Prophylactic for DVT Prevention
    1. Heparin 5000 Units SQ every 8-12 hours
  4. Dosing: Therapeutic Dosing by Weight based Calculations
    1. Measure
      1. Total body weight (TBW) in kilograms
      2. Height in inches
    2. Calculate Lean Body Weight (LBW) in kilograms
      1. Male: 50 + 2.3 x (height in inches - 60)
      2. Female: 45 + 2.3 x (height in inches -60)
    3. Calculate Dosing Weight
      1. Non-Obese
        1. Dosing Weight (kg): TBW above
      2. Obese (TBW > 1.4 x LBW)
        1. Dosing Weight (kg): (0.4 x TBW) + LBW
    4. Calculate heparin starting doses
      1. Bolus: 80 Units/kg
        1. Maximum: 10,000 units
        2. Round to nearest 100 units
      2. Maintenance: 18 Units/kg/hour
        1. Round to nearest 50 units per hour
  5. Labs: Therapeutic Dosing Initial (before Heparin)
    1. Partial Thromboplastin Time (aPTT)
    2. ProTime
    3. Complete Blood Count (CBC)
  6. Labs: Therapeutic Dosing Recurring Labs
    1. Partial Thromboplastin Time (aPTT)
      1. 6 hours after bolus and then per nomogram
    2. Platelets
      1. Every 3 days
      2. Minimum: 150,000
  7. Protocol: Therapeutic Dosing Nomogram
    1. aPTT under 40
      1. Give 6000 unit bolus
      2. Increase maintenance rate by 6 units/kg/hour
      3. Recheck aPTT in 6 hours
    2. aPTT 40-49
      1. Give 3000 unit bolus
      2. Increase maintenance rate by 4 units/kg/hour
      3. Recheck aPTT in 6 hours
    3. aPTT 50-59
      1. Give 1500 unit bolus
      2. Increase maintenance rate by 2 units/kg/hour
      3. Recheck aPTT in 6 hours
    4. aPTT 60-85
      1. No change in dosing
      2. Recheck aPTT on the next morning
    5. aPTT 86-100
      1. Decrease maintenance rate by 1 unit/kg/hour
      2. Recheck aPTT in 6 hours
    6. aPTT over 100
      1. Stop Heparin for 60 minutes
      2. Decrease maintenance rate by 2 units/kg/hour
      3. Recheck aPTT in 6 hours
  8. Adverse Effects
    1. Bleeding complications
    2. Heparin Induced Thrombocytopenia

Heparin (C0019134)

Definition (MSH)A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts.
Definition (CSP)poly(glucosamine sulfate-glucuronic acid); endogenous mucopolysaccharide with antithrombin and lipotropic activities; USP injection is used as an anticoagulant.
Definition (SPN)Enzyme preparations are products that are used in the histopathology laboratory for the following purposes: (1) To disaggregate tissues and cells already in established cultures for preparation into subsequent cultures (e.g., trypsin); (2) To disaggregate fluid specimens for cytological examination (e.g., papain for gastric lavage or trypsin for sputum liquefaction); (3) To aid in the selective staining of tissue specimens (e.g., diastase for glycogen determination).
Definition (NCI)A drug that helps prevent blood clots from forming. It belongs to the family of drugs called anticoagulants (blood thinners).
Definition (NCI)A sulphur-rich glycosaminoglycan with anticoagulant property. Heparin binds to antithrombin III to form a heparin-antithrombin III complex. The complex binds to and irreversibly inactivates thrombin and other activated clotting factors, such as factors IX, X, XI, and XII, thereby prevents the polymerization of fibrinogen to fibrin and the subsequent formation of clots.
ConceptsCarbohydrate (T118) , Pharmacologic Substance (T121) , Biologically Active Substance (T123)
EnglishHeparin, HEPARIN PREPARATION, Heparinic Acid
Spanishheparina
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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