, heparin is widely used as a "thinner" of the blood. In fact, there are certain categories of patients for whom, either due to greater blood coagulability, or due to the presence of certain diseases or risk factors, it is essential to prevent the formation of abnormal blood clots (so-called thrombi).
The classic therapeutic applications of heparin are therefore represented by atrial fibrillation, deep vein thrombosis and acute coronary syndrome (ischemic heart disease attack); its use is also indicated in patients undergoing major surgery and in those on dialysis (dialysis is a technique used to purify the blood when the kidneys are not functioning properly).
As regards in particular the use of heparin in deep vein thrombosis, the use of the medicine has essentially a preventive purpose and aims to prevent the formation of thrombus within the venous circulation. The most fearful complication of this event is the so-called pulmonary embolism, resulting from the "obstruction of" an artery of the lungs by a fragment of thrombus detached from the clot, and then pushed by the blood to the right heart and from there to the pulmonary circulation.
molecular (smaller molecules) and standard or unfractionated heparins; the main difference between the two categories concerns the methods of administration.Assuming that heparin cannot be administered orally (it would be digested, therefore inactivated) and that as such it must necessarily be injected, low molecular weight heparins can be administered subcutaneously, on a single daily occasion (to times twice) and also in the home environment. Standard heparins, on the other hand, are administered intravenously, by infusion or several times a day, and their use is generally reserved for the hospital setting.
Both types of heparin possess a binding site with antithrombin III, a plasma glycoprotein with an anticoagulant action independent of vitamin K. This molecule - enhanced in its action up to 2000 times by binding with heparin - is able to inhibit several clotting factors, in particular thrombin and factor Xa. While unfractionated heparin possesses inhibitory activity towards both factor Xa and thrombin, low molecular weight heparins preferentially inactivate factor Xa.
bpm (low molecular weight) must occur in well vascularized areas but far from the muscles; classically they are performed at the level of the adipose tissue of the buttocks or of the antero-lateral or postero-lateral abdominal area. The injection is performed by lifting between the fingers an adequately disinfected fold of adipose tissue and orienting the needle in a perpendicular or slightly inclined direction depending on its thickness.After the injection, a cotton swab soaked in disinfectant must be pressed for a few seconds on the injection site, without rubbing. In any case, it is essential to refer first of all to the instructions received from your doctor, also regarding dosage, duration of therapy with heparin, frequency and method of injection.
If you miss a dose
Should the patient miss a dose, for example due to forgetting, this should be done as soon as possible, unless the time of the next injection is near; for no reason, in fact, a double dose of medicinal. Also in this sense it is very important to respect the recommendations of the doctor, who must always be contacted in the presence of doubts or worrying symptoms: in the event of an overdose of heparin there is in fact a real risk of going into more or less serious bleeding. In this regard, it may be useful to set up a card in which to write down the various injections according to the schedule established by the doctor.
, aspirin, diclofenac, ketoprofen, etc.) for example, can enhance the anticoagulant activity of the drug favoring the appearance of bleeding. Therefore, before taking any type of drug during therapy with heparin it is very important to obtain the preventive clearance from the doctor ; analogous discourse for supplements and herbal preparations.
Important Recommendations
Particular attention must also be paid to avoiding more or less serious traumatic episodes (from contact sports to too vigorous tooth brushing).
Small haemorrhages can occur not only during the therapy, but also for a few weeks after the end of the same; the doctor will be alerted immediately in the presence of widespread bruising, difficulty in stopping the loss of nosebleeds (epistaxis), blood in the urine (haematuria), stools that are blackish, tarry or with obvious traces of blood and major gum bleeding.
Contraindications
Absolute contraindications to the use of heparin are represented by thrombocytopenia, by bleeding syndromes in progress and by the existence of allergic phenomena (for example hypersensitivity to substances of swine origin or to heparin itself). Caution during the menstrual period and in the presence of diseases liver, intestinal or gastric disorders, uncontrolled hypertension, bleeding disorders and blood disorders (e.g. haemophilia).
During the medical interview which is a prelude to the beginning of therapy, it is also important to expose a possible state of pregnancy, for which the absolute safety of heparin has not yet been established.
