Heparin is typically the preferred agent for inpatient parenteral anticoagulation. Serious side effects include bleeding complications and type 2 heparin -induced thrombocytopenia HIT , which causes arterial and venous thromboembolisms due to an antibody -mediated aggregation of platelets.
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If HIT is suspected, treatment involves discontinuing all heparins and beginning non- heparin anticoagulation usually argatroban. Platelets should always be monitored during heparin therapy and a baseline should be established before commencing treatment! References:   [;].
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The effect of most parenteral anticoagulants depends on native antithrombin. In patients with antithrombin III deficiency e. References:   . Synthetic heparin. Heparin treatment requires regular monitoring of the platelet count , especially for UFH , even before starting treatment. The significantly increased risk of bleeding is the main side effect of all anticoagulants! References:  . We list the most important adverse effects.
The selection is not exhaustive. References:   . References: . We list the most important contraindications. References:   . Clinical science Parenteral anticoagulants are routinely indicated for the prevention and treatment of venous thromboembolism.
HIT can be differentiated into type 1 asymptomatic , and type 2 , which is antibody -related and prognostically worse. References:   We list the most important adverse effects.
Low-dose therapy DVT prophylaxis for prolonged bedrest , peri- and postoperative state, immobility High-dose therapy Atrial fibrillation DVT , acute arterial thrombosis , pulmonary embolism Acute coronary syndrome Mechanical heart valve replacement VTE prophylaxis for patients with hemodialysis , heart - lung machine, etc. While similar in mechanism to unfractionated heparin, LMWH is cleared renally, has a much longer half-life and less commonly causes heparin induced thrombocytopenia HIT.
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Monitoring drug activity is not usually necessary for LMWH unlike unfractionated heparin which requires close monitoring of the activated partial thromboplastin time aPTT. LMWH is used to treat acute coronary syndromes and venothromboembolism.
LMWH is also used for venothromboembolism prophylaxis in hospitalized patients. Bleeding, heparin induced thrombocytopenia HIT , elevated liver function testing, aldosterone inhibitory effect causing hyperkalemia. Tell us what you think about Healio. Patient Information What is Hypertension? What is Atrial Fibrillation?