Presentation
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. [ncbi.nlm.nih.gov]
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
- Intravenous Administration
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]
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]
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]
Neurologic
- Severe Headache with Sudden Onset
headaches of sudden onset sudden loss of coordination sudden shortness of breath for no apparent reason sudden slurred speech sudden vision changes unusual bleeding or bruising For Healthcare Professionals Applies to heparin: injectable kit, injectable [drugs.com]
Workup
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]
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 [web.archive.org]
Patients With Acute Renal Insufficiency 1 3 Completed Treatment Postoperative Hemorrhages 1 3 Completed Treatment Primary PCI - STEMI 1 3 Completed Treatment Pulmonary Embolism 2 3 Completed Treatment Recurrent Abortion 1 3 Completed Treatment Severe [drugbank.ca]
Prognosis
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]
Abstract Glioblastoma multiforme (GBM) is the most common and aggressive brain cancer, and despite treatment advances, patient prognosis remains poor. [stemcell.com]
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
Pregnancy LMW heparins are being used increasingly in pregnant women with prosthetic heart valves and for the prevention and treatment of venous thromboembolism. [web.archive.org]
Heparin is also used to treat blood clots when they do form, helping prevent the clot from increasing in size and preventing additional clots from occurring. [verywellhealth.com]
Heparin is a drug that works as an anticoagulant, which means that it prevents blood clots from forming and prevents existing blood clots from expanding. It was orginally extracted from the liver, but now it is mostly manufactured synthetically. [cwladis.com]
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]