Indications: for the prevention and treatment of thrombotic or embolic
diseases (such as myocardial infarction, thrombophlebitis, pulmonary embolism,
etc.); Diffuse intravascular coagulation (DIC) due to various causes; It is also
used in hemodialysis, extracorporeal circulation, catheterization, microvascular
surgery and other operations and anticoagulation treatment of some blood samples
Packing specification: 12,500 units *10
Usage and dosage: SUBcutaneous injection: 1. Deep subcutaneous injection: 5000 ~ 10000 units for the first time, 8000 ~ 10000 units every 8 hours or 15000 ~ 20000 units every 12 hours thereafter; The total amount is about 30,000 ~ 40,000 units every 24 hours, and generally satisfactory results can be achieved. 2. Preventive treatment: High-risk thrombotic patients are mostly used after abdominal surgery to prevent deep venous thrombosis. 5000 units of heparin should be injected subcutaneously 2 hours before surgery, but the anesthetic method should avoid epidural anesthesia, and then 5000 units should be given every 8 to 12 hours for a total of 7 days. Intravenous administration: 1. Intravenous injection: 5000 ~ 10000 units for the first time, then diluted with sodium chloride injection or 100 units /kg every 4 hours according to body weight. 2. Intravenous infusion: 20,000 ~ 40,000 units per day were added to 1000ml sodium chloride injection for continuous infusion. An initial dose of 5000 units may be given intravenously before infusion.
Adverse reaction: low toxicity, the main adverse reaction is that too much medication can cause spontaneous bleeding, so the coagulation time should be measured before each injection. If serious bleeding occurs after injection, emergency treatment can be performed by intravenous injection of protamine sulfate (LMG protamine sulfate can neutralize 150U heparin). Occasionally cause anaphylaxis and thrombocytopenia usually occur in the first 5-9 days, so the platelet count should be monitored regularly within 1 month after the beginning of treatment. Occasional hair loss and diarrhea. It can also cause osteoporosis and spontaneous fractures. Liver function is bad long-term use can cause antithrombin - Ⅲ depletion and thrombophilia.
Contraindication: to heparin allergy, the person that has spontaneous haemorrhage tendency, blood clotting is slow (be like hemophilia, purpura, thrombocytopenia), canker disease, wound, postpartum haemorrhage and serious liver function is incomplete person is forbidden.
Precautions: Clotting time should be measured regularly during medication.
Medication for pregnant women: use in late pregnancy and postpartum, which may increase the risk of maternal bleeding, should be used with caution.
Children medication: 1. Intravenous injection of 50 units /kg at a time according to body weight, followed by 50-100 units every 4 hours. 2. Intravenous infusion 50 units /kg according to body weight, followed by 24-hour infusion of 20,000 units /m2 per day according to body surface area, followed by slow infusion of sodium chloride injection.
Elderly drug use: elderly people over 60 years old, especially elderly women are more sensitive to this drug, easy to bleeding during the use of drugs, should reduce the amount and strengthen the use of follow-up.
Drug interactions: 1. When used in combination with the following drugs, the risk of bleeding may be increased. (1) coumarin and its derivatives, can lead to severe factor Ⅸ bleeding due to a lack of. (2) Aspirin and non-steroidal anti-inflammatory and analgesic drugs, including mefenac and salicylic acid, can inhibit platelet function and induce gastrointestinal ulcer bleeding. (3) Dipyridamole and dextran may inhibit platelet function. (4) Adrenocorticosteroids and adrenocorticotropin are easy to induce gastrointestinal ulcer bleeding. (5) Other beneficial uric acid, tissue plasminogen activator (T-PA), urokinase, streptokinase, etc. 2. Heparin and sodium bicarbonate, sodium lactate and other drugs to correct acidosis can promote the anticoagulation effect of heparin. 3. The mixed injection of heparin and hyaluronidase can not only relieve myodynia, but also promote heparin absorption. However, heparin can inhibit the activity of hyaluronidase, so the two should be used together temporarily, and should not be kept for a long time after drug mixing. 4. Heparin can act with insulin receptors, thus changing the binding and action of insulin. Hypoglycemia caused by heparin has been reported. 5. The following drugs and this has the compatibility taboo: kanamycin, amikacin, soft erythromycin, erythromycin, gentamycin sulfate, lactose acid hydrogenation of sodium succinate, polymyxin B, adriamycin, tobramycin, vancomycin, meng cephalosporin cefepime, oxygen more pp, cefalotin sodium, chloroquine, chlorpromazine, promethazine, narcotic analgesics. 6. Methimazole and prothiouracil have synergistic effect with the product.
Pharmacological action: due to its physical and chemical properties with strong negative charge, this product can interfere with many links in the process of blood coagulation, and has anticoagulant effect in vivo and in vitro. Its mechanism of action than more complex, mainly through and antithrombin Ⅲ (AT - Ⅲ), and enhance the latter to activate Ⅱ, Ⅸ, Ⅹ, Ⅺ and Ⅻ inhibition of clotting factors. The results involved preventing platelet aggregation and destruction and preventing the formation of thrombin. Preventing prothrombin from becoming prothrombin; It inhibits thrombin, thereby preventing fibrinogen from becoming fibrin.