Heparin parenteral

Promoting an Optimai Response to Therapy Heparin preparations, unlike warfarin, must be given by the parenteral route, preferably SC or IV The onset of anticoagiilation is almost immediate after a single dose. Maximum effects occur witiiin 10 minutes of administration. Clotting time will return to normal witiiin 4 hours unless subsequent doses are given. 

Heparin must be given parenterally as it is not absorbed by the gut due to the large size and charge of its constituent molecules. Because of its short half-life (approximately 1 hour) UFH must be given frequently or as a continuous infusion. 

Angiotensin converting enzyme inhibitors, atracurium, P-lactams, heparin, iron (parenteral), losartan, and streptokinase... 

The present chapter deals with different calculations associated with parenteral medications which include rate of flow of intravenous fluids, parenteral insulin and heparin administration, reconstitution of powdered medications, and milliequivalent and milliosmole calculations pertinent to injectable medications. 

Drugs that may affect penicillins include allopurinol, aminoglycosides (parenteral), aspirin, beta blockers, chloramphenicol, erythromycin, ethacrynic acid, furosemide, indomethacin, phenylbutazone, probenecid, sulfonamides, tetracycline, and thiazide diuretics. Drugs that may be affected by penicillins include aminoglycosides (parenteral), anticoagulants, beta blockers, chloramphenicol, cyclosporine, oral contraceptives, erythromycin, heparin, and vecuronium. 

Heparin is prescribed on a unit (lU) rather than milligram basis. Tlie dose must be determined on an individual basis. Heparin is not absorbed after oral administration and therefore must be given parenterally. Intravenous administration results in an almost immediate anticoagulant effect. There is an approximate 2-hour delay in onset of drug action after subcutaneous administration. Intramuscular injection of heparin is to be avoided because of unpredictable absorption rates, local bleeding, and irritation. Heparin is not bound to plasma proteins or secreted into breast mUk, and it does not cross the placenta. 

Parenteral 2.5, 5, 7.5, 10 mg in single-dose pre-filled syringes Heparin sodium (generic, Liquaemin)... 

Heparin is a large, sugarlike molecule that is poorly absorbed from the gastrointestinal tract. Consequently, heparin must be administered parenterally. The agent was traditionally administered through intravenous (IV) infusion or repeated IV injection... 

Amphotericin B is the only polyene antibiotic given parenterally. When the intravenous route is contemplated, amphotericin B is dispersed fresh, as discussed, and infused slowly. Amphotericin B should not be administered rapidly because this causes cardiac toxicity. Heparin (1000 units) is often added to the infusion suspension to avert the risk of thrombophlebitis. Amphotericin B can also precipitate normocytic or normochromic anemia, leukopenia, and thrombocytopenia. 

The two commonly administered anticoagulant therapies3 are parenteral heparin, a highly sulfated glycosaminoglycan, and oral warfarin 2, a vitamin K antagonist (which acts by indirectly inhibiting several steps of the coagulation pathway). The major... 

ALISKIREN ANTICOAGULANTS -PARENTERAL Risk of hyperkalaemia with heparin Additive effect Monitor serum potassium closely... 

ACE INHIBITORS, ANGIOTENSIN II RECEPTOR ANTAGONISTS ANTICOAGULANTS -PARENTERAL T risk of hyperkalaemia with heparins Heparin inhibits aldosterone secretion, causing hyperkalaemia Monitor potassium levels closely... 

VASODILATOR ANTIHYPERTENSIVES ANTICOAGULANTS -PARENTERAL Possible t risk of bleeding with iloprost Anticoagulant effects of heparins t by a mechanism that is uncertain at present Monitor APTT closely... 

FONDAPARINUX ANTICOAGULANTS-PARENTERAL t risk of bleeding when heparins are given with fondaparinux Combined anticoagulant effect Manufacturers recommend avoiding co-administration... 

NSAIDs ANTICOAGULANTS-PARENTERAL 1. Risk of prolonged bleeding when ketorolac is co-administered with dalteparin (but not enoxaparin), and intravenous diclofenac is given with heparins 2. t risk of hyper-kalaemia when ketorolac is given with heparin f. Uncertain 2. Heparin inhibits aldosterone secretion, causing hyperkalaemia 1. Avoid co-administration 2. Monitor potassium levels closely... 

Direct-acting heparin, hirudin, bivalirudin and argatroban are rapidly effective, act for only a few hours and must be given parenterally. 

Infusion phlebitis presents a problem in parenteral nutrition. Various alternative techniques of administration have been compared in order to identify means of countering this problem (9). Mechanical trauma appears to be a causative factor it can be reduced by hmiting the time of exposure of the vein wall to nutrient infusion and by minimizing the amount of prosthetic material within the vein (10). This is hkely to be even more important in small veins. In one study the addition of heparin (500 U/1) and hydrocortisone (5 micrograms/ml) significantly reduced the risk of thrombophlebitis from 0.43 to 0.11... 

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