Unfractionated Heparin

Aka: Unfractionated Heparin, Heparin

advertisement

II. Mechanism

  1. Potentiates Antithrombin III (AT III)
  2. See Intrinsic Clotting Pathway

III. Dosing: Prophylactic for DVT Prevention

  1. Heparin 5000 Units SQ every 8-12 hours

IV. 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

V. Labs: Therapeutic Dosing Initial (before Heparin)

  1. Partial Thromboplastin Time (aPTT)
  2. ProTime
  3. Complete Blood Count (CBC)

VI. 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

VII. 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

VIII. Adverse Effects

  1. Bleeding complications
  2. Heparin Induced Thrombocytopenia

IX. Management: Reversal

  1. Protamine

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term "Unfractionated Heparin." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

Related Studies

Cost: Medications

heparin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
HEPARIN SODIUM 10,000 UNIT/ML VIAL Generic $1.79 per ml
HEPARIN SODIUM 5,000 UNIT/ML VIAL Generic $1.30 per ml
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

advertisement