Category:
Description:
Indications:
-
Venous
thrombosis, pulmonary embolism, peripheral arterial embolism
-
Coagulopathies,
DVT/PE prophylaxis, clotting prevention in arterial and heart surgery
-
Blood
transfusions, extracorporeal circulation, dialysis and blood samples
Contraindications:
-
Severe
thrombocytopenia, uncontrolled bleeding (except when due to DIC)
-
Suspected
intracrainial hemorrhage, shock, severe hypotension
Precautions:
-
Pregnancy
category C; does not cross placental barrier; not excreted in breast
milk
-
IM
injection (avoid due to risk for hematoma)
-
Elderly,
children, diabetes, renal
insufficiency, severe hypertension
-
Subacute
bacterial endocarditis, acute nephritis, peptic ulcer disease, sever
renal disease
Adverse
Reactions (Side Effects):
-
CNS:
fever, rash
-
CV:
allergic vasospastic reactions, shock
-
EENT:
lacrimation, rhinitis
-
GI:
nausea, vomiting
-
GU:
hematuria, priapism
-
HEME:
hemorrhage, thrombocytopenia, white clot syndrome
-
RESP:
anaphylactoid reactions, asthma
-
SKIN:
chills, cutaneous necrosis, delayed transient alopecia, erythema,
histamine-like reactions, local irritation, urticaria
|
Dosage:
Administered
SC and IV
-
Adult:
-
DVT/PE:
-
IV
INF 50-100 u/kg initially, then 15-25 u/kg/hr, adjusted based
on APTT
results; intermittent IV 10,000u initially, then 75-125 u/kg
every 4-6 hours
-
SC
10,000-20,000u initially, then 8,000-10,000u every 8 hours or
15,000-20,000u every 12 hours
-
Prevent
DVT/PE:
-
Child:
-
IV
INF 50 u/kg initially, then 15-25 u/kg/hr, increase dose by 2-4
u/kg/hr every 6-8 hours based on aPTT results
-
Intermittent
IV 50-100 u/kg initially, then 50-100 u/kg every 4 hours
|
Source:
Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
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