The following is the Heparins manufacturer Kowloon Pharmaceutical Co., Ltd.
to introduce the cautions of taking heparin sodium:
1.(1) A history of allergic diseases and asthma; (2) Oral surgery and other operations prone to bleeding; (3) those who have taken enough anticoagulants orally; (4) Excessive menstrual flow; (5) During pregnancy and postpartum (hepatocellular carcinoma increases the risk of maternal bleeding during the last 3 months of pregnancy or postpartum).
2. Effects of drugs on the elderly: Elderly people over 60 years old (especially elderly women) are more sensitive to heparin and prone to bleeding during medication, so dosage should be reduced and follow-up should be strengthened.
3. Effects of drugs on test value or diagnosis :(1) heparin can prolong prothrombin time, increase the retention time of sodium sulfbromophthalide (BSP) test and present false positive reaction, resulting in increased concentrations of T3 and T4, thereby inhibiting the release of pituitary thyrotropin; (2) When heparin dose reaches 15000 ~ 20000U, serum cholesterol concentration decreases.
4. Before treatment, the coagulation time of whole blood should be measured (test tube method), and the prothrombin time and prothrombin time should be measured by one-stage method; During the treatment, the coagulation time of whole blood (tube method), hematocrit, stool occult blood test, urine occult blood test and platelet count should be measured.
5. In clinical practice, heparin dosage was adjusted according to partial thrombin time (APTT). The coagulation time should be maintained at 2 ~ 3 times before treatment, and THE APTT should be 1.5 ~ 2.5 times before treatment. The heparin dosage and the interval time of administration should be adjusted at any time. On the first day of treatment, the above observed values should be observed before each medication, and measured several times a day thereafter, and once a day for maintenance dosage; For the elderly, hypertension and liver and kidney dysfunction, because they are sensitive to heparin response, more attention should be paid to monitoring.
6. When long-term anticoagulation therapy is needed, oral anticoagulation with diccoumarin can be added while heparin is applied, and heparin should be discontinued after 36 ~ 48h, and then oral anticoagulants should be used alone to maintain anticoagulation.
7. If heparin fails to be taken orally, intravenous injection, intravenous drip and deep subcutaneous injection can be adopted. Intramuscular injection is generally not recommended, as it can lead to hematoma at the injection site; Subcutaneous injection should go deep into the adipose layer (such as the iliac crest and abdominal adipose tissue), the injection site should be constantly changed, do not move the needle when injecting, the injection site should not be rubbed, but local oppression.
8. Intramuscular injection of other drugs should be avoided during administration.
9. Rapid metabolism of heparin, slight excess, stop use; Severe overdose of protamine can be neutralized by slow intravenous injection, usually 1mg protamine can neutralize 100U of heparin. If heparin has been injected for more than 30 minutes, the dosage of protamine should be halved.
10. Heparin can interfere with prothrombin time measurement, so the test must be repeated 4h after heparin is used.
11. If the AT - Ⅲ decrease in plasma, curative effect is poorer, heparin plasma transfusion or the AT - Ⅲ.
12. Low dose heparin is usually used clinically to prevent thrombosis, while high dose heparin is used clinically to treat thrombosis.
13. The following drugs and liver as compatibility taboo: amikacin sulfate, thiamethoxam organism, cephalosporin cefepime meng, cefoperazone, cefalotin sodium, more celebration of sulfate big mildew toxin, toxins, tobramycin, lactose acid erythromycin, vancomycin, slime molds element B, adriamycin, soft erythromycin, hydrocortisone sodium succinate, narcotic analgesics, chlorpromazine, promethazine, etc.
14. People who are allergic to heparin should be on the alert. In case of allergy, especially to pork, beef or other animal protein, 6 to 8mg of heparin can be given as the test amount first, and the whole amount can be given only if there is no special reaction after 0.5h.
15. Heparin, unlike thrombolytic drugs (e.g., urokinase), is insoluble in established thrombi.
16. Heparin should not be used as a prophylactic drug during ophthalmic and neurological operations and in patients with hemorrhagic diseases, because heparin is likely to cause intraorbital and intracranial hemorrhage.
17. The tendency to spontaneous bleeding is the most important risk factor for heparin overuse. Early signs of excess include mucosal and wound bleeding, gingival bleeding during brushing, skin ecchymosis or purpura, and nosebleed. Excessive menstrual flow, etc.; Severe internal bleeding signs, manifested as abdominal pain, abdominal distension, back pain, paralytic intestinal obstruction, hemoptysis, hematemesis, hematuria, blood stool and persistent headache.
18. For intravenous administration, it is better to pump with micro infusion pump, press 100U/kg to pump, and test APTT at any time to adjust the dosage.