Heparin

Provider Level

RN/Paramedic

Class

Anticoagulant

Mechanism of Action

Binds to antithrombin III, inactivating thrombin and clotting factor Xa, preventing the conversion of fibrinogen to fibrin.

Indications

Acute myocardial infarction, pulmonary embolism, deep vein thrombosis, maintenance of IV line patency.

Contraindications

Active bleeding, severe thrombocytopenia, history of heparin-induced thrombocytopenia, severe uncontrolled hypertension, recent intracranial hemorrhage.

Routes

IV, SQ

Onset / Duration

Onset: Immediate (IV), 20-60 minutes (SQ). Duration: 2-6 hours.

Adverse Effects

Hemorrhage, bruising, heparin-induced thrombocytopenia, hypersensitivity reactions.

Precautions & Interactions

High risk of bleeding. Use caution in patients with peptic ulcer disease, hepatic or renal disease, or those on concomitant antiplatelet therapy.

Special Considerations

Does not lyse existing clots. Monitor for bleeding. Protamine sulfate is the reversal agent.