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Application of heparin sodium
Name SODIUM HEPARIN INJECTION
Drug Classes Anticoagulants and Thrombolytic Drugs
Character This product is colorless or light yellow clear liquid.
Pharmacological toxicity is due to its strong negative charge physicochemical properties, which can interfere with many aspects of the hemagglutination process and have anticoagulant effect in vivo and in vitro. Its mechanism of action is complex, mainly through the combination with antithrombin III (AT-III), and enhance the latter's inhibition of activated coagulation factors II, IX, VII and VII. The consequences involve preventing platelet aggregation and destruction, hindering the formation of thrombin activating enzymes, preventing prothrombin from turning into thrombin, and inhibiting thrombin, thereby preventing fibrinogen from turning into fibrin. Pharmacokinetics This product is not absorbed by oral administration, but well absorbed by subcutaneous, intramuscular or intravenous injection. However, 80% of heparin binds to plasma albumin, partially adsorbed by blood cells and partially diffused into extravascular space. Because of its high molecular weight, it can not pass through pleura, peritoneum and placenta. This product is mainly metabolized in the reticuloendothelial system and excreted in the kidney, a small amount of which is excreted in the original form. The excretion after intravenous injection depends on the dosage. When 100, 400 or 800 U/kg was given once, t 1/2 was 1 hour, 2.5 hours and 5 hours respectively. In patients with chronic hepatorenal insufficiency and obesity, metabolic excretion is delayed and accumulation is possible. The onset time of this product is related to the mode of administration. Intravenous injection can exert the maximum anticoagulant effect immediately, but the individual difference is great. Subcutaneous injection can prolong the overall duration obviously due to the absorption of individual difference. The plasma heparin concentration was not affected by dialysis. Indications are used to prevent and treat thrombosis or embolic diseases (such as myocardial infarction, thrombophlebitis, pulmonary embolism), diffuse intravascular coagulation (DIC) caused by various causes, and anticoagulation of some blood samples or instruments in hemodialysis, cardiopulmonary bypass, catheterization, microvascular surgery, etc.
usage and dosage
(1) Deep subcutaneous injection: 5000-10000 units for the first time, 8000-10000 units for every 8 hours or 15000-20000 units for every 12 hours after the injection; the total amount of 3000O-40000 units per 24 hours, generally can achieve satisfactory results.
(2) Intravenous injection: 5000-10000 units for the first time, then, or 100 units/kg per 4 hours according to body weight, diluted with sodium chloride injection.
(3) Intravenous drip: 20 000-40 000 units per day, added to 1 000 ml sodium chloride injection for continuous drip. 5000 units of intravenous injection can be used as the initial dose before dripping.
(4) Preventive treatment: Most patients with high-risk thrombosis are used after abdominal surgery to prevent deep venous thrombosis. 5 000 units of heparin were injected subcutaneously 2 hours before surgery, but epidural anesthesia should be avoided, and then 5 000 units every 8-12 hours for about 7 days. The toxicity of adverse reactions is low. The main adverse reactions are that too much medicine can cause spontaneous bleeding. Therefore, the coagulation time should be measured before each injection. If serious bleeding occurs after injection, protamine sulfate can be injected intravenously for first aid (lmg protamine sulfate can neutralize 150U heparin). Occasionally, allergic reactions and thrombocytopenia often occur in the first 5 to 9 days of treatment. Therefore, platelet count should be monitored regularly within one month of starting treatment. Occasionally one-off hair loss and diarrhea. It can also cause osteoporosis and spontaneous fracture. Long-term use of antithrombin-III in patients with liver dysfunction may lead to depletion of antithrombin-III and tendency of thrombosis. Contraindications are forbidden for those who are allergic to heparin, have spontaneous tendency to bleed, have slow blood coagulation (such as hemophilia, purpura, thrombocytopenia), ulcer, trauma, postpartum hemorrhage and severe hepatic insufficiency.
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