Heparin Rob Holland
Name /bks53161deglinsmddisk/enoxaparin 09:28AM Plate # 0-Composite pg 3 # 3 Canadian drug name. Genetic Implication. Policies, i.e. Treatment with low molecular weight heparin (LMWH) during lower leg plaster cast immobilization following surgical or conservative treatment. Rob GHH Nelissen, PhD, MD. Den Haag Zuid Holland 2597 AX Netherlands.
| VANCOMYCIN HYDROCHLORIDE (van-koe-mye'sin) Vancocin Classifications:antiinfective; antibiotic Pregnancy Category: B |
125 mg, 250 mg capsules; 1 g, 10 g oral powder; 500 mg, 1 g injection
Prepared from Streptomyces orientalis, with bactericidal and bacteriostatic actions. Acts by interfering with cell membrane synthesis in multiplying organisms.
Active against many gram-positive organisms, including group A beta-hemolytic Streptococci, Staphylococci, Pneumococci, Enterococci, Clostridia, and Corynebacteria. Gram-negative organisms, mycobacteria, and fungi are highly resistant.
Parenterally for potentially life-threatening infections in patients allergic, nonsensitive, or resistant to other less toxic antimicrobial drugs. Used orally only in Clostridium difficile colitis (not effective by oral route for treatment of systemic infections).
Known hypersensitivity to vancomycin, allergy to corn or corn products, previous hearing loss, concurrent or sequential use of other ototoxic or nephrotoxic agents, IM administration.
Neonates; children; older adults; impaired kidney function, renal failure, renal impairment, concomitant administration of aminoglycosides; hearing impairment; colitis, inflammatory disorders of the intestine; pregnancy (category B), lactation.
| Systemic Infections Adult:IV 500 mg q6h or 1 g q12h, infuse over 60–90 min Child:IV 40 mg/kg/d divided q6h, infuse over 60–90 min Neonate:IV 10 mg/kg/d divided q8–12h, infuse over 60–90 min Clostridium difficile Colitis Adult:PO 125–500 mg q6h Child:PO 40 mg/kg/d divided q6h (max: 2 g/d) |
- Oral solution is prepared by adding to 10 g oral powder 115 mL of distilled water. The solution may be further diluted in 10 g of water.
| Intravenous PREPARE:Intermittent: Reconstitute 500 mg vial or 1 g vial with 10 mL or 20 mL, respectively, of sterile water for injection to yield 50 mg/mL. Further dilute each 1 g with at least 200 mL of D5W, NS, or RL. ADMINISTER:Intermittent: Give a single dose at a rate of 10 mg/min or over NOT LESS than 60 min. Avoid rapid infusion, which may cause sudden hypotension. Monitor IV site closely; necrosis and tissue sloughing will result from extravasation. INCOMPATIBILITIESSolution/additive:Aminophylline,barbiturates, cefotaxime,chloramphenicol,chlorothiazide,dexamethasone,heparin,sodium bicarbonate,warfarin.Y-site:Albumin,aztreonam,cefepime,cefotaxime,cefotetan,cefoxitin,ceftazidime,ceftriaxone,cefuroxime,foscarnet,heparin,idarubicin,nafcillin,omeprazole,piperacillin/tazobactam,ticarcillin,ticarcillin/clavulanate,warfarin. |
- Store oral and parenteral solutions in refrigerator for up to 14 d; after further dilution, parenteral solution is stable 24 h at room temperature.
Assessment & Drug Effects
- Monitor BP and heart rate continuously through period of drug administration.
- Lab tests: Monitor urinalysis, kidney & liver functions, and hematologic studies periodically.
- Monitor serial tests of vancomycin blood levels (peak and trough) in patients with borderline kidney function, in infants and neonates, and in patients >60 y.
- Assess hearing. Drug may cause damage to auditory branch (not vestibular branch) of eighth cranial nerve, with consequent deafness, which may be permanent.
- Be aware that serum levels of 60–80 mcg/mL are associated with ototoxicity. Tinnitus and high-tone hearing loss may precede deafness, which may progress even after drug is withdrawn. Older adults and those on high doses are especially susceptible.
- Monitor I&O: Report changes in I&O ratio and pattern. Oliguria or cloudy or pink urine may be a sign of nephrotoxicity (also manifested by transient elevations in BUN, albumin, and hyaline and granular casts in urine).
Patient & Family Education
- Notify physician promptly of ringing in ears.
- Adhere to drug regimen (i.e., do not increase, decrease, or interrupt dosage. The full course of prescribed drug therapy must be completed).
- Do not breast feed while taking this drug.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug
Generic Name: heparin (injection) (HEP a rin)
Brand Names:Hep-Pak (obsolete), Heparin Lock Flush (obsolete), Hep-Pak CVC (obsolete), Hep-Lock (obsolete), Heparin Sodium ADD-Vantage
Medically reviewed by Kaci Durbin, MD Last updated on Jan 6, 2020.
- Overview
What is heparin injection?
Heparin is an anticoagulant (blood thinner) that prevents the formation of blood clots.
Heparin is used to treat and prevent blood clots caused by certain medical conditions or medical procedures. It is also used before surgery to reduce the risk of blood clots.
Do not use heparin injection to flush (clean out) an intravenous (IV) catheter. A separate product is available to use as catheter lock flush. Using the wrong type of heparin to flush a catheter can result in fatal bleeding.
Important Information
Do not use heparin injection to flush (clean out) an intravenous (IV) catheter, or fatal bleeding could result. A separate product is available to use as catheter lock flush.
You should not use heparin if you have uncontrolled bleeding or a severe lack of platelets in your blood. Do not use this medicine if you have ever been diagnosed with “heparin-induced thrombocytopenia,” or low platelets caused by heparin or pentosan polysulfate.
Heparin increases your risk of bleeding, which can be severe or life-threatening. You will need frequent tests to measure your blood-clotting time.
Call your doctor or seek emergency medical attention if you have unusual bleeding or bruising, severe stomach or back pain, unusual tiredness, a nosebleed, blood in your urine or stools, coughing up blood, or any bleeding that will not stop.
Heparin can cause you to have bleeding episodes while you are using it and for several weeks after you stop.
Certain medicines can increase your risk of bleeding while you are using heparin, such as aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) including ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), nabumetone (Relafen), piroxicam (Feldene), and others. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Do not use heparin injection to flush (clean out) an intravenous (IV) catheter, or fatal bleeding could result. A separate product is available to use as catheter lock flush.
Before taking this medicine
You should not use this medicine if you are allergic to heparin or pork products, or if you have:
a history of low platelets in your blood caused by using heparin or pentosan polysulfate;
a severe lack of platelets in your blood; or
uncontrolled bleeding.
You may not be able to use heparin if you are unable to receive routine blood-clotting tests at the proper intervals during treatment.
To make sure heparin is safe for you, tell your doctor if you have ever had:
an infection of the lining of your heart (also called bacterial endocarditis);
severe or uncontrolled high blood pressure;
a bleeding or blood clotting disorder;
a stomach or intestinal disorder;
liver disease;
if you use a blood thinner (warfarin, Coumadin, Jantoven) and you have routine 'INR' or prothrombin time tests; or
if you are having a menstrual period.
It is not known whether heparin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. You may need to use a form of heparin that does not contain a preservative.
You should not breastfeed while using this medicine.
How should I use heparin injection?
Heparin is injected under the skin or as an infusion into a vein. A healthcare provider will give your first dose and may teach you how to properly use the medication by yourself.
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don't understand all instructions.
Prepare an injection only when you are ready to give it. Do not use the medicine if it has changed colors or has particles in it. Call your pharmacist for new medicine.
Do not use a prefilled syringe when giving this medicine to a child. The prefilled syringe contains more than a child's dose of heparin.
Heparin increases your risk of bleeding, which can be severe or life-threatening. You will need frequent tests to measure your blood-clotting time. The timing of these tests is very important in helping your doctor determine whether it is safe for you to continue using this medicine.
If you need surgery, dental work, or a medical procedure, tell the care provider ahead of time that you are using heparin.
Store at room temperature away from moisture and heat.
Use a needle and syringe only once and then place them in a puncture-proof 'sharps' container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.
You may be switched from injectable heparin to an oral (taken by mouth) blood thinner. Do not stop using the injection until your doctor tells you to. You may need to use both the injection and the oral forms for a short time.
See also:
Heparin dosage information (in more detail)
What happens if I miss a dose?
Call your doctor for instructions if you miss a dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include easy bruising, nosebleeds, blood in your urine or stools, black or tarry stools, or any bleeding that will not stop.
What should I avoid while using heparin injection?
Avoid medication errors by using only the form and strength your doctor prescribes.
Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID). Using an NSAID with heparin may cause you to bruise or bleed easily.
Heparin injection side effects
Get emergency medical help if you have signs of an allergic reaction to heparin:nausea, vomiting, sweating, hives, itching, trouble breathing, swelling of your face, lips, tongue, or throat, or feeling like you might pass out.
Heparin may cause you to bleed more easily, which can be severe or life-threatening. You may also have bleeding on the inside of your body. Seek emergency medical attention if you have:
skin warmth or discoloration;
chest pain, irregular heartbeats;
shortness of breath, dizziness, anxiety, sweating;
any unusual bleeding or bruising;
severe pain or swelling in your stomach, lower back, or groin;
Kamen rider kabuto episode 2. dark or blue-colored skin on your hands or feet;
nausea, vomiting, loss of appetite;
unusual tiredness;
any bleeding that will not stop; or
nosebleed, blood in your urine or stools, black or tarry stools, or coughing up blood or vomit that looks like coffee grounds.
Heparin can cause you to have bleeding episodes while you are using it and for several weeks after you stop.
Bleeding may be more likely in older adults, especially women over 60 years of age
Stop using this medicine and call your doctor at once if you have:
skin changes where the medicine was injected;
fever, chills, runny nose, or watery eyes;
easy bruising, unusual bleeding, purple or red spots under your skin; or
signs of a blood clot - sudden numbness or weakness, problems with vision or speech, swelling or redness in an arm or leg.
Common heparin side effects may include:
unusual bleeding or bruising;
uncontrolled bleeding;
allergic reactions; or
abnormal liver function tests.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect heparin injection?
Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others. Using an NSAID with heparin may cause you to bruise or bleed easily.
Tell your doctor about all your other medicines, especially:
a blood thinner - warfarin, Coumadin, Jantoven;
digitalis;
tetracyclines;
nicotine; or
antihistamines.
This list is not complete and many other drugs may interact with heparin. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
See also:
Heparin drug interactions (in more detail)
Further information
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use heparin only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright 1996-2020 Cerner Multum, Inc. Version: 15.01.
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