The effect of heparin sodium and matters needing attention

  The heparin sodium injection was 0.2ml clear liquid from colorless to light yellow. 5000IU

  indications

  Treatment of acute deep vein thrombosis; To prevent clotting in the extracorporeal circulation system during hemodialysis and blood filtration in persons with acute renal failure or chronic renal insufficiency; Treatment of unstable coronary artery disease, such as unstable angina and non-Q-wave myocardial infarction; Prevent blood clots associated with surgery.

  contraindications

  Allergic to heparin sodium injection or other low molecular weight heparin and/or heparin; Severe clotting disease; Injury or operation of the central nervous system, eyes and ears; Local anesthesia or lumbar puncture should not be performed in patients undergoing acute deep vein thrombosis (DVT) because of the increased risk of bleeding

  Special warnings and precautions

  1. This product should be used carefully in patients with thrombocytopenia, platelet defects, severe liver and kidney dysfunction, uncontrolled hypertension, hypertension or diabetic retinopathy. It should also be used with caution in patients who have recently undergone surgery when using large doses of heparin sodium.

  2. It is recommended that platelet technique should be examined and monitored regularly before starting heparin sodium treatment, especially during the first week of treatment.

  3. Platelet count examination should be done before the use of this product for the treatment of acute deep vein thrombosis, and regular review should be performed. Treatment should be discontinued when thrombocytopenia occurs (< 100,000 / L) and resumed only after in vitro studies have shown that heparin does not cause platelet aggregation. Platelet count should be checked at least twice a week after treatment begins, especially during the first three weeks of treatment.

  5. Generally speaking, there are few times to adjust the dose when long-term hemodialysis patients apply this product, so there are few times to detect anti-XA concentration. Patients undergoing acute hemodialysis have shorter treatment intervals and should be fully monitored against -XA concentrations.

  5. Patients with unstable angina pectoris or non-Q-wave myocardial infarction may receive thrombolytic therapy if they have transmural myocardial infarction. Discontinuation of this product due to thrombolysis is not necessary, but may increase the risk of bleeding.

  6. In order to reduce the risk of bleeding, it is better to insert or remove the catheter before heparin sodium injection exerts its anticoagulant effect when combined spinal or epidural anesthesia is used. Catheters should be inserted or removed 12 hours after the last dose of heparin to prevent DVT, or 24 hours after the patient is at increased risk of bleeding. Contraindicated use in patients undergoing acute deep vein thrombosis with local epidural or spinal anesthesia or puncture. Remove catheter for at least 4 hours before use of heparin sodium injection.

  Adverse reactions

  Bleeding; Subcutaneous hematoma at injection site and temporary mild thrombocytopenia, usually reversible during treatment; Temporary mild to moderate liver transaminase increase can be seen

  Drug overdose

  Protamine can inhibit the anticoagulation effect of heparin sodium. The prolongation of clotting time caused by this product can be completely neutralized, but the anti-XA activity can only be about 25-50%. 1 mg of protamine inhibits the anti-XA action of 100 IU of heparin sodium (low molecular weight heparin sodium). Protamine itself has an inhibitory effect on hemostasis at the primary stage, so it can only be used in emergency situations

  Drug interaction

  Concurrent use of drugs that have an impact on hemostasis, such as thrombolytic drugs, acetylsalicylic acid, non-steroidal anti-inflammatory drugs, vitamin K antagonists and glucan may enhance the anticoagulant effect of heparin sodium. However, low doses of acetylsalicylic acid may be administered orally in patients with unstable coronary artery disease such as unstable angina and non-Q-wave myocardial infarction, except in patients with specific contraindications.