The drug "Heparin" is able to slow down the ability of blood to clot. Release the drug in ampoules and glass bottles of 5 ml. They contain a solution for injection, in which the activity of the active substance is 5000 IU.
Pharmacological properties
The drug "Heparin" (injections) is an anticoagulant. It is able to slow down the process of fibrin formation, reduce the rate of
blood coagulation factors, and in high concentrations, reduce the activity of thrombin. Even small doses of the drug are enough to increase the fibrinolytic activity of the blood.
To reduce the viscosity of the main body fluid, heparin injections are used. The use (the dose for injection is selected by the doctor individually) is based on the fact that this drug accumulates on the endothelium, blood elements and increases their negative charge. Due to this property, the adhesion and aggregation of platelets, leukocytes and red blood cells is reduced.
In addition, "Heparin" prevents the development of atherosclerosis, has anti-allergic and weak vasodilator effects. This is due to the fact that it binds a number of elements of the complement system and reduces its activity. Also, the drug prevents the formation of immunoglobulins, cooperation of lymphocytes, binds serotonin and histamine.
Indications for use
As a rule, if there are problems with blood coagulation, heparin is prescribed. Injections or intravenous infusions are recommended in such cases:
1) deep vein thrombosis, coronary arteries, pulmonary embolism;
2) myocardial infarction;
3) unstable angina pectoris;
4) the first phase of DIC;
5) atrial fibrillation, which is accompanied by thromboembolism.
Also, in hospitals, when performing operations using extracorporeal blood circulation methods, heparin can be prescribed. Injections are given intravenously or subcutaneously, if necessary, blood transfusion, hemodialysis to prevent coagulation of this biological fluid.
The tool is used for the treatment and prevention of disorders of microcirculation and microthrombosis, for example, with renal vein thrombosis, lupus nephritis, glomerulonephritis, bacterial endocarditis, mitral heart disease, hemolytic uremic syndrome.
Drug action
If you have been prescribed “Heparin” injections in your stomach, then you should know that you will have to do them often enough. The action of the drug occurs quickly, but it is short-lived. So, with the introduction of the drug intravenously, blood coagulation slows down almost immediately, the effect lasts about 4-5 hours. With the introduction of it intramuscularly, the effect occurs after 15-30 minutes and lasts 6 hours, and with injections under the skin is observed after 40-60 minutes, lasts 8 hours. The therapeutic effect to prevent blood clots lasts much longer.
The drug "Heparin" enhances blood flow in the kidneys, increases the resistance of blood vessels in the brain, has a lipid-lowering effect. In addition, the tool helps to reduce surfactant activity in the lungs, suppresses excessive synthesis of aldosterone in the adrenal cortex, enhances the active effect of parathyroid hormone, binds adrenaline.
Features of use
Often people suffering from coronary heart disease are prescribed Heparin (injections). The price of this drug seems to some high. A package of 5 ampoules of 5 ml with an activity of 5,000 IU in 1 ml will cost 500-600 rubles. But you can’t refuse to use it. Indeed, in patients with ischemia, the Heparin drug reduces the risk of myocardial infarction, the development of coronary artery thrombosis and sudden death. Moreover, the use of the drug can reduce the likelihood of recurring heart attacks and significantly reduce the percentage of deaths in such patients.
With venous thrombosis and pulmonary thromboembolism, high doses of Heparin are prescribed. Injections (the instruction allows you to figure out how to put them correctly) are done after a certain period of time. But, true, in some cases, to obtain an instant effect, it is desirable to administer the drug intravenously.
Also, heparin is prescribed for the prevention of thromboembolism, for example, after surgical interventions. In this case, it is prescribed in small doses.
Ways to use
Only the doctor should select the necessary dosage and method of using the drug, depending on the condition of the patient and the reasons why he needs this drug. The drug can be administered intravenously in the form of a continuous infusion or regular injections. Also, in some cases, subcutaneous or intramuscular injections can be prescribed .
To prevent thrombosis, the medicine can be administered subcutaneously in 1 ml (5000 IU) twice a day. The need for this is indicated by the instructions for use attached to the heparin preparation. Injections, as a rule, are given in the abdomen, in its anterolateral wall. To do this, take a thin needle and insert it deep into the fold of the skin. It is formed if you squeeze between the thumb and forefinger the abdomen in the navel. The injection site must be alternated. In exceptional cases, injections can be made in the upper thigh or shoulder.
Dosage selection
For therapeutic purposes, in hospitals, intravenous infusions are often prescribed. For adult patients, the dosage of the drug is 1000 IU / hour. But before installing the dropper, to achieve the maximum effect, it can be injected jet into the vein in an amount of 5000 IU. The exact dose is selected by the doctor depending on the situation and the patient’s weight.
If intravenous infusion is not possible, then the drug can be administered subcutaneously: 2 ml of the drug (which corresponds to 10,000 IU) 4 times a day. At the maximum dosage, as a rule, use the drug for up to 10 days.
The required amount of medicine is selected after evaluating the results of the tests. Particular attention is paid to APTT (activated partial thromboplastin time).
During blood transfusion, the donor, as a rule, is administered 7.5-10 thousand IU of Heparin.
Special Therapy
In acute myocardial infarction, 10-15 thousand IU are immediately administered intravenously, and then continue to use it so that the patient receives about 40,000 IU on the first day, but the exact dose is selected depending on the patient’s weight. This is necessary so that the blood coagulates 2.5-3 times slower. Starting from the second day, the dosage is reduced. It is important that the clotting time is 1.5-2 times higher than normal. Treatment with this drug is continued for up to 8 days. To cancel it, the daily dose is reduced by 5-10 thousand IU, but the intervals between injections do not increase. After cancellation, they switch to indirect anticoagulants. It can be such means as Fenilin, Neodikumarin and others.
Acute arterial or venous obstruction also requires a special approach. For treatment, intravenous administration of heparin is prescribed for 3-5 days at a dosage of 400-450 IU for each kg of patient weight. That is, a patient of average physique and growth should receive about 30-40 thousand IU of Heparin per day. Then they switch to its fractional administration, but the dosage increases to 600 IU / kg, while 100 IU / kg should enter the body in one injection. Treatment can last up to 16 days. A few days before discontinuation of the drug, its amount is gradually reduced. Treatment continues with the use of indirect anticoagulants .
special instructions
Despite the fact that some talk about the possibility of intramuscular administration of the drug, this is not recommended because hematomas often form at the injection site. To dilute the drug using a solution of 0.9% NaCl.
It is also important to know that during treatment with Heparin, it is not worth making any intramuscular injections and conducting a biopsy of organs. When using it, it is necessary to monitor the state of hemocoagulation. In the first week of therapy, blood is checked every two days, starting from the second week it can be done every 3 days.
Although the drug does not pass into breast milk, it is advisable to stop lactation during therapy. It was found that the drug in some cases leads to damage to the spine and the development of osteoporosis. Problems begin after 2-4 weeks of taking the drug.
Separately, it is worth noting that the medicinal solution may turn yellow, but this does not affect its pharmacological properties or the tolerance of Heparin. Injections, the price of which can significantly affect the budget when it is prescribed in high dosages, can be done even at home alone.
Contraindications
Like any other means, you can not use the drug "Heparin" with individual intolerance. It is not prescribed for any bleeding. The exception is hemorrhage, which occurs with a pulmonary infarction (expressed as hemoptysis) or kidneys (accompanied by hematuria).
Contraindications also include:
- hemorrhagic diathesis and other diseases in which blood coagulation is impaired;
- increased vascular permeability, for example, with Verlhof disease;
- bacterial endocarditis;
- bleeding history;
- hypoplastic and aplastic anemia, chronic and acute leukemia;
- Severe impairment of liver and kidney function;
- venous gangrene;
- acute development of aneurysm of the heart.
Precautionary measures
In addition to direct contraindications, there is a list of situations in which it is necessary to assess all the possible risks when taking the heparin drug. Injections and intravenous administration are done only in exceptional cases and under the supervision of specialists in case of tumor and ulcerative lesions of the gastrointestinal tract, high pressure, in the postpartum and postoperative period, with the exception of vascular operations.
A few words about the treatment of expectant mothers. Despite the fact that treating women in an interesting position with the remedy we are considering is undesirable (this can lead to the development of complications), heparin injections in the stomach are prescribed in some cases during pregnancy. The likelihood of adverse effects ranges from 10 to 21%. Although for normal pregnancy, the risk of complications does not exceed 3.6%.
It is worth noting that the consequences of possible thromboembolism in expectant mothers are more life-threatening than taking Heparin. Injections during pregnancy are done only under medical supervision and only if there are absolute indications. But the medication can cause bleeding, osteoporosis and thrombocytopenia. Through the placenta, the drug does not penetrate.
Possible analogues and patient reviews
Often, those who have been prescribed the drug “Heparin” (injections in the stomach), the price seems too high. But when used as a preventive measure, 1 bottle may last for several days. So, the package, in which there are 5 bottles, can last for a couple of weeks. And in high doses, the drug is usually used no more than 10-14 days.
Nevertheless, many people want to know from other patients whether to buy this medicine, they are looking for reviews about the Heparin drug. Analogues of this medication are also of interest to them. So, if there are problems with blood coagulation, then the tool is very effective and allows you to achieve the desired therapeutic effect very quickly. This is confirmed by both doctors and their patients.
But anticoagulants Troparin, Heparin Sandoz, Heparin Sodium Brown, Heparin-Ferein and other analogues can also be prescribed instead. The dosage of these drugs should be selected only by the doctor, taking into account the results of the patient’s tests, his state of health and the indications for which the medicine is prescribed.
In certain cases, doctors recommend low molecular weight heparins, for example, Fraxiparin, Fragmin, Zibor, Enixum, Fraxiparin forte. The effect of their use, as evidenced by patient reviews, is almost the same as that of the medicine we are considering.