Presentation
Heparan sulfate is a ubiquitous compound present in all species analyzed whereas chondroitin sulfate was present in 20 species and heparin-like compounds in 12 species of the invertebrates. [ncbi.nlm.nih.gov]
No significant amounts of chondroitin sulfates were present. Histological data showed that the sulfate-labeled GAGs were present mainly in exterior pericellular and basement membrane locations of gills and mantle. [doi.org]
Heparin is presented in mast cell, liver and lungs. Although its function is unknown, it is widely used as an anticoagulant to prevent blood clotting in vivo and in vitro. [echelon-inc.com]
Entire Body System
- Swelling
Check with your doctor or nurse immediately if any of the following side effects occur while taking heparin: Less common Abdominal or stomach pain or swelling back pain or backaches bleeding from the gums when brushing teeth blood in the urine constipation [drugs.com]
Call your doctor or nurse if you have redness, swelling, burning, or pain where you injected the heparin. Use a new needle and syringe each time. If you miss a dose contact your doctor right away. [healthnavigator.org.nz]
SLIDESHOW Heart Disease: Symptoms, Signs, and Causes See Slideshow Heparin Consumer Information Get emergency medical help if you have signs of an allergic reaction: nausea, vomiting, sweating, hives, itching, trouble breathing, swelling of your face, [rxlist.com]
Our gelatin/heparin cryogel showed gelatin concentration-dependent mechanical properties, swelling ratios, interconnected porosities, and elasticities. [pubs.acs.org]
Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. [uwhealth.org]
- Collapse
Additional symptoms may include gradual neurological deterioration, seizures, intracranial hemorrhage, hematologic abnormalities, skin breakdown, hepatic and renal failure, hypotension, bradycardia, and cardiovascular collapse. [web.archive.org]
A PE may cause breathing problems, chest pain and coughing up blood but a large PE can cause collapse and may be life threatening. However, the risk of developing a pulmonary embolus, once a DVT has been diagnosed and treated, is extremely small. [nbt.nhs.uk]
Noncardiogenic pulmonary edema and peripheral vascular collapse following cardiopulmonary bypass: rare protamine reaction? Ann Thorac Surg. 1980; 29:20-5. 112. Holland CL, Singh AK, McMaster PR et al. [drugs.com]
- Intravenous Administration
Salmon heparin activity was recovered in plasma samples expressed as antifactor Xa activity after intravenous administration. [ncbi.nlm.nih.gov]
The heparin-induced elevation of the plasma FFA was blocked by the intravenous administration of protamine sulfate 5 min prior to the heparin in 4 control subjects; however, the rise in the TfT 4 was not inhibited. [academic.oup.com]
In patients with STEMI, intravenous administration of up to 5000 U of unfractionated heparin was permitted before arrival at the catheterization laboratory. [nejm.org]
The preferred route of UFH administration is either by a continuous intravenous administration or by subcutaneous injection, whereas LMWH is administered by subcutaneous injection. [cochranelibrary.com]
Hematological
- Easy Bruising
Call your doctor at once if you have easy bruising or unusual bleeding, such as a nosebleed, black or bloody tarry stools, or any bleeding that will not stop. [uwhealth.org]
Common side effects of Heparin are: easy bleeding and bruising; pain, redness, warmth, irritation, or skin changes where the medicine was injected; itching of your feet; or bluish-colored skin. [rxlist.com]
Cardiovascular
- Heart Disease
The HC group had significantly fewer desaturation or arrest events (P KEYWORDS: Cardiac surgery; Congenital heart surgery; Cyanotic heart disease; Shunts [ncbi.nlm.nih.gov]
Read the entire FDA prescribing information for Heparin (Heparin) QUESTION In the U.S., 1 in every 4 deaths is caused by heart disease. See Answer Health Solutions From Our Sponsors CONTINUE SCROLLING FOR RELATED SLIDESHOW [rxlist.com]
Scientists cast new light on function of long-mysterious PCSK9 mutation High levels of low-density lipoproteins, parcels of lipids and protein that carry cholesterol, are a leading risk factor for heart disease. [news-medical.net]
Disease / Coronary Heart Disease (CHD) / Heart Diseases / Myocardial Infarction / Myocardial Ischemia 1 3 Completed Treatment Angioplasty, Transluminal, Percutaneous Coronary 2 3 Completed Treatment Bacterial Infections / Sepsis 1 3 Completed Treatment [drugbank.ca]
- Vascular Disease
Author information 1 Department of Internal Medicine, Medical Faculty of the University of Ljubljana, Ljubljana, Slovenia - [email protected]. 2 Department of Vascular Disease, University Medical Center Ljubljana, Ljubljana, Slovenia - pavel.poredos [ncbi.nlm.nih.gov]
Clinical correlation of mesenteric vascular disease in older patients. Aging Clin Exp Res. 2012 Jun. 24(3 Suppl):43-6. [Medline]. Di Fabio F, Obrand D, Satin R, Gordon PH. [medscape.com]
disease; and presumed life expectancy of less than 30 days. [bmj.com]
453 (1.4) 227 (1.6) 226 (1.3) 0.0448 Other neurological disorders 4,682 (14.6) 2,202 (15.1) 2,480 (14.2) 0.0187 Peripheral vascular disease 2,134 (6.6) 980 (6.7) 1,154 (6.6) 0.6490 Psychoses 1,295 (4.0) 574 (3.9) 721 (4.1) 0.4066 Pulmonary circulation [journalofhospitalmedicine.com]
(CVD) / Coronary Heart Disease (CHD) / Heart Diseases / Myocardial Infarction / Myocardial Ischemia 1 3 Completed Treatment Angioplasty, Transluminal, Percutaneous Coronary 2 3 Completed Treatment Cardiovascular Disease (CVD) / Coronary Artery Bypass [drugbank.ca]
Skin
- Alopecia
Musculoskeletal Frequency not reported: Significant bone demineralization, spontaneous bone fracture Postmarketing reports: Osteoporosis[Ref] Dermatologic Frequency not reported: Ecchymoses Postmarketing reports: Cutaneous necrosis, delayed transient alopecia [drugs.com]
[…] severe thrombocytopenia, usually after 5 days of heparin, with thrombo-embolic complications requiring discontinuation of treatment; • localised reactions at the injection site, rarely, necrosis; • allergic reactions, osteoporosis after prolonged use, alopecia [medicalguidelines.msf.org]
Rarely, LMWH therapy can cause alopecia. The extent of hair loss can vary greatly. All cases of LMWH-related alopecia have resolved upon cessation of therapy. LMWH Antidote The antidote for LMWH is Protamine sulphate. [rch.org.au]
Miscellaneous Osteoporosis following long-term administration of high doses of heparin, cutaneous necrosis after systemic administration, suppression of aldosterone synthesis, delayed transient alopecia, priapism and rebound hyperlipemia on discontinuation [rxlist.com]
Bleeding High blood potassium level (hyperkalaemia) Decrease in the number of platelets in the blood (thrombocytopenia) Breakdown of skin cells Thinning of the bones (osteoporosis) with long term use Hair loss (alopecia) may be experienced after prolonged [netdoctor.co.uk]
- Purpura
Skin necrosis manifests as sharply demarcated tender red or purple patches ( purpura ) which develop black centres and may lead to dry gangrene. A net-like or branching, retiform, pattern of purpura may also be seen. [dermnetnz.org]
Hematologic: conditions associated with increased bleeding tendencies such as hemophilia, some purpuras and thrombocytopenia. In patients with a history of heparin-induced thrombocytopenia (HIT), danaparoid and ancrod are considered alternatives. [rxmed.com]
Pancreas 1 1, 2 Not Yet Recruiting Treatment End Stage Renal Disease (ESRD) 1 1, 2 Recruiting Prevention Thoracic Surgery / Thromboprophylaxis 1 1, 2 Recruiting Prevention Urinary Tract Infections, Recurrent 1 1, 2 Recruiting Treatment Henoch-Schoenlein Purpura [drugbank.ca]
[…] detect. 500 Use with extreme caution in patients with an increased risk of hemorrhage. 373 e 464 471 Such patients include those with subacute bacterial endocarditis; ulcerative GI lesions; hemorrhagic blood dyscrasias (e.g., hemophilia, some vascular purpuras [web.archive.org]
- Eczema
Se han descrito diversas lesiones cutáneas adversas, entre ellas urticaria, necrosis cutánea, eczema localizado en el punto de inyección o eczema diseminado. [medigraphic.com]
[…] anaphylactic shock Postmarketing reports: Chills, fever, urticaria, asthma, rhinitis, lacrimation, headache, nausea, vomiting, anaphylactoid reactions, shock, itching, burning[Ref] Local Frequency not reported: Erythematous nodules, infiltrated and sometimes eczema-like [drugs.com]
Face, Head & Neck
- Epistaxis
Often the first sign of bleeding may be epistaxis, hematuria or melena. Bleeding may be from any site and can be difficult to detect, i.e., retroperitoneal bleeds. Bleeding may also occur from surgical sites. [rxmed.com]
Minor hemorrhages were those that were confirmed to be overt and to have some clinically important feature, such as epistaxis, ecchymosis, hematoma, or macroscopic hematuria but that did not meet the criteria for major hemorrhage. [doi.org]
Urogenital
- Kidney Failure
Unfractioned heparin is foremost applied in patients with kidney failure. [flexikon.doccheck.com]
Preventing blood from clotting when it is filtered through an 'artificial kidney' (haemodialysis) machine as part of the management of kidney failure. [netdoctor.co.uk]
LMWHs are more dependent on renal function for their excretion than unfractionated heparin so their biological half-life may be prolonged in patients with kidney failure and therefore their use in the setting of creatinine clearance rate (CrCl) <30 mL [en.wikipedia.org]
Workup
Improved workup for glycosaminoglycan disaccharide analysis using CE with LIF detection. ELECTROPHORESIS 2008, 29 (22), 4538-4548. DOI: 10.1002/elps.200800335. Sabine Wegehingel, Christoph Zehe, Walter Nickel. [doi.org]
Serum
- Partial Thromboplastin Time Prolonged
Biological tests showed that their APTT (activated partial thromboplastin time) prolonging activity and intrinsic factor Xase complex (factor IXa-VIIIa-Ca 2+ -PL complex) inhibitory activity were both reduced in FCS derivatives with lower Mw and DF. [ncbi.nlm.nih.gov]
- Lipase Increased
[Ref] Cardiovascular Postmarketing reports: Hemorrhage, retroperitoneal hemorrhage[Ref] Hematologic Very common (10% or more): Thrombocytopenia (up to 30%) Frequency not reported: Plasma lipoprotein lipase increased Postmarketing reports: Heparin resistance [drugs.com]
- Potassium Increased
[…] hypersensitivity reactions[Ref] Endocrine Frequency not reported: Hypoaldosteronism Postmarketing reports: Adrenal hemorrhage, acute adrenal insufficiency, fatal adrenal hemorrhage, aldosterone synthesis suppressed[Ref] Metabolic Frequency not reported: Plasma potassium [drugs.com]
- Activated Partial Thromboplastin Time Prolonged
Biological tests showed that their APTT (activated partial thromboplastin time) prolonging activity and intrinsic factor Xase complex (factor IXa-VIIIa-Ca 2+ -PL complex) inhibitory activity were both reduced in FCS derivatives with lower Mw and DF. [ncbi.nlm.nih.gov]
Treatment
LMW heparins are replacing unfractionated heparin for the prevention and treatment of venous thromboembolism and the treatment of non-ST-segment-elevation acute coronary syndromes. [ncbi.nlm.nih.gov]
Treatment of venous thromboembolism Meta-analyses of RCTs which have directly compared once-daily or twice-daily LMW heparin therapy with unfractionated heparin therapy as initial treatment for patients with venous thromboembolism, both in the hospital [mja.com.au]
Applications: For the treatment of: Acute myocardial infarction Prophylactic and curative treatment of arterial and venous thromboembolism Pulmonary embolism Prevention of pulmonary and deep venous thromboembolism during pregnancy Peripheral artery diseases [bioiberica.com]
Also, the trials were heterogeneous with respect to duration of treatment. While most trials have involved at least 3 days of treatment, treatment duration in individual trials varied from as little as 2 days to as much as 8 days. [thelancet.com]
Prognosis
Abstract Glioblastoma multiforme (GBM) is the most common and aggressive brain cancer, and despite treatment advances, patient prognosis remains poor. [stemcell.com]
Prognosis and prophylaxis of this life-threatening disorder, which can develop from the use of unfractionated or (less commonly) low-molecular-weight heparin, are also discussed [lsmuni.lt]
Adverse impact of bleeding on prognosis in patients with acute coronary syndromes. Circulation 2006;114:774-782 21. Zeymer U, van ’t Hof A, Adgey J, et al. [nejm.org]
Etiology
The wide range of etiologic microbes and the ongoing development of resistance to antimicrobials with specific mechanisms of action make this an appropriate target for applying a nonspecific antimicrobial therapeutic. [ncbi.nlm.nih.gov]
Vasopasm has been reported 6 to 10 days after starting heparin; the etiology is thought to be allergic. Vasospasm often appears in a limb where an artery has recently been catheterized. The affected limb is usually painful, ischemic and cyanotic. [rxmed.com]
AT deficiency can be either congenital or acquired in etiology. [journals.lww.com]
Epidemiology
He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]
Emmanuel Spanakis, Human DNA Sampling and Banking, Molecular Genetic Epidemiology — A Laboratory Perspective, 10.1007/978-3-642-56207-5_2, (27-53), (2002). [doi.org]
[citation needed] Epidemiology[edit] Up to 8% of patients receiving heparin are at risk to develop HIT antibodies, but only 1–5% on heparin will progress to develop HIT with thrombocytopenia and subsequently one third of them may suffer from arterial [en.wikipedia.org]
Hylek, MD, MPH, General Medicine Division/Clinical Epidemiology Unit, Ninth Floor, Massachusetts General Hospital, 50 Staniford St, Boston, MA 02114. Accepted for publication June 19, 2002. [jamanetwork.com]
Epidemiology and mortality of venous thromboembolism across patient populations: a systematic literature review. Value in Health. 2013;16:A1-A298. [ Links ] 5. Guijarro Merino R, Montes Santiago J, San Román Terán CM. [scielo.isciii.es]
Pathophysiology
The exact pathophysiology is not well understood. Hemorrhagic bullous dermatosis is a rare cutaneous reaction that is temporally associated with the initiation of heparin products. [ncbi.nlm.nih.gov]
Held PG (1990) Pathophysiology of cardiopulmonary bypass. In: Hemsley FA, Martin DE (eds) The practice of cardiac anesthesia. Little, Brown, Boston Google Scholar 13. [link.springer.com]
Although the clinical significance of ACE lesions was initially a source of debate and discussion, it is clear that their pathophysiology is ischemic injury (6). [electrophysiology.onlinejacc.org]
Glycosaminoglycans (GAGs), located on animal cell membranes and in the extracellular matrix, are important molecules in cellular communication during development, in normal physiology and pathophysiology. [doi.org]
Prevention
[…] compares anticoagulation using unfractionated heparin, low molecular weight heparin and heparinoids In this section: Unfractionated heparin Low molecular weight heparins Heparinoids Unfractionated heparin Unfractionated heparin (UFH) has been used for the prevention [thrombosisadviser.com]
Pregnancy LMW heparins are being used increasingly in pregnant women with prosthetic heart valves and for the prevention and treatment of venous thromboembolism. [mja.com.au]
Heparin increases the action of factors in the body that normally prevent the formation of blood clots. Normally there is balance between the factors in the body that create blood clots and those that prevent the formation of blood clots. [myvmc.com]