Heparin in prevention

Wolfram R, Leborgne L, Cheneau E, Pinnow EE, Canos DA, Hellinga D et al. Comparison of effectiveness and safety of three different antithrombotic regimens (bi-valirudin, eptifibatide, and heparin) in preventing myocardial ischemia during percutaneous coronary intervention. Am J Cardiol 2003 92(9) 1080-3. 

Leizorovicz A, Haugh MC, Chapuis FR, Samama MM, Boissel JP. Low molecular weight heparin in prevention of perioperative thrombosis. BMJ 1992 305(6859) 913-20. 

Kakkar VV, Corrigan TP, Spindler J, et al. Efficacy of low doses of heparin in prevention of deep vein thrombosis after major surgery. Lancet 1972 300 101-106. 

Controlled trial of two regimens of subcutaneous heparin in prevention of postoperative deep-vein thrombosis. Lancet, I, 1133. 

Neri Serneri GG, Rovelli F, Gensini GF, Pirelli S, Camovali M, Fortini A. Effectiveness of low-dose heparin in prevention of myocardial reinfarction. Lancet 1987 1 937-942. 

Heparin inhibits the formation of fibrin clots, inhibits the conversion of fibrinogen to fibrin, and inactivates several of the factors necessary for the clotting of blood. Heparin cannot be taken orally because it is inactivated by gastric acid in the stomach therefore, it must be given by injection. Heparin has no effect on clots that have already formed and aids only in preventing the formation of new blood clots (thrombi). The LMWHs act to inhibit clotting reactions by binding to antithrombin HI, which inhibits the synthesis of factor Xa and the formation of thrombin. 

Ms. Jackson, age 56years, is hospitalized with a venous thrombosis. The primary health care provider orders SC heparin. In developing a care plan for Ms. Jiekson, discuss the nursing interventions that would be most important to prevent complications while administering heparin. Provide a rationale for each intervention. 

Heparin in mixtures of glycosaminoglycans can also be titrated to a turbidimetric end-point with such quaternary ammonium salts as CPC, at a sufficiently high concentration of salt to prevent complex-formation by less-charged polyanions.38... 

Either low-dose unfractionated heparin or low-molecular weight heparin are effective A in preventing deep vein thrombosis Stress ulcer prophylaxis... 

A major focus of drug development has been to develop orally active anticoagulants that do not require monitoring. Rivaroxiban is the first oral factor Xa inhibitor to reach phase III clinical trials. The safety and efficacy of rivaroxiban appears to be at least equivalent, and possibly superior, to LMW heparins for prevention of deep vein thrombosis no routine monitoring is required. This drug is also in clinical trials for treatment of deep vein thrombosis and prevention of stroke in atrial fibrillation. 

Brinkhous KM, Smith HR Warmer ED, Seegers WH. The inhibition of blood clotting an unidentified substance which acts in conjunction with heparin to prevent the conversion of prothrombin into thrombin. Am J Physiol 1939 125 683-687,... 

Serruys PW, Herrman J-PR, Simon R, et al. A comparison of hirudin with heparin in the prevention of restenosis after coronary angioplasty. N Engl J Med 1995 333 757-763,... 

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