"Heparin" (injections): application, instructions, reviews, doses. Application of injections "Heparin" in pregnancy

The drug "Heparin" is able to slow the ability of the blood to clot. They produce medicament in ampoules and glass bottles of 5 ml. They contain a solution for injections, in which the activity of the active substance is 5000 IU.

Pharmacological properties

The drug "Heparin" (injections) is an anticoagulant. It is able to slow the formation of fibrin, reduce the rate of clotting factors, and in high concentrations - reduce thrombin activity. Even small doses of the drug are sufficient to increase the fibrinolytic activity of the blood.

To reduce the viscosity of the body's main body fluid, injections of "Heparin" are used. The application (a dose for injections is chosen by the physician individually) is based on the fact that this agent accumulates on the endothelium, the elements of the blood and increases their negative charge. Due to this property, adhesion and aggregation of platelets, leukocytes and erythrocytes is reduced.

In addition, "Heparin" interferes with the development of atherosclerosis, has anti-allergic and weak vasodilating effect. This is due to the fact that it binds a number of elements of the complement system and reduces its activity. Also, the drug prevents the formation of immunoglobulins, the cooperation of lymphocytes, binds serotonin and histamine.

Indications for use

As a rule, in the presence of problems with blood coagulability, injections of the drug "Heparin" are prescribed. Injections or intravenous infusions are recommended in such cases:

1) thrombosis of deep veins, coronary arteries, thromboembolism of the pulmonary artery;

2) myocardial infarction;

3) unstable angina;

4) the first phase of DIC syndrome;

5) atrial fibrillation, which is accompanied by thromboembolism.

Also in hospitals, when performing operations with the use of extracorporeal circulation methods, he can prescribe the means "Heparin". Injections intravenously or subcutaneously, if necessary, blood transfusions, hemodialysis to prevent the coagulation of this biological fluid.

The agent is used for the therapy and prevention of microcirculation disorders and microthrombogenesis, for example, with renal vein thrombosis, lupus nephritis, glomerulonephritis, bacterial endocarditis, mitral heart disease, hemolyticuremic syndrome.

Effect of the drug

If you were prescribed injections of "Heparin" in the stomach, then you know: they will have to be done often enough. The effect of the drug comes quickly, but it is short-lived. So, with the introduction of the drug intravenously, blood coagulation slows down almost immediately, the action lasts about 4-5 hours. With the introduction of its intramuscular effect occurs after 15-30 minutes and lasts 6 hours, and when injected under the skin observed after 40-60 minutes, lasts 8 hours. The therapeutic effect aimed at preventing the formation of blood clots, lasts much longer.

The drug "Heparin" enhances the blood flow in the kidneys, increases the resistance of blood vessels in the brain, has a hypolipidemic effect. In addition, the drug helps reduce activity in the lungs of the surfactant, suppresses excessive synthesis in the cortex of the adrenal glands of aldosterone, strengthens the active influence of parathyroid hormone, binds adrenaline.

Features of use

Often people suffering from ischemic heart disease are prescribed "Heparin" (injections). The price of this drug seems high to some. Packing of 5 ampoules of 5 ml with an activity of 5 000 IU in 1 ml will cost 500-600 rubles. But you can not refuse to use it. After all, in patients with ischemia, the drug "Heparin" reduces the risk of myocardial infarction, development of coronary thrombosis and sudden death. Moreover, the use of the drug can reduce the likelihood of recurrent myocardial infarction and significantly reduce the percentage of deaths in such patients.

With venous thrombosis and thromboembolism of the pulmonary arteries, high doses of the drug "Heparin" are prescribed. The injections (the instruction allows to understand how to put them correctly) are made after a certain period of time. But, the truth, in some cases for reception of an instant effect it is desirable to enter means intravenously.

Also, the "Heparin" remedy is prescribed for the prevention of thromboembolism, for example, after surgical interventions. In this case, appoint it in small doses.

Ways to use

Only the doctor should choose the necessary dosage and method of using the drug, depending on the patient's condition and the reasons for which he needs this drug. The agent can be administered intravenously in the form of continuous infusion or regular injections. In some cases, subcutaneous or intramuscular injections may be prescribed .

To prevent thrombosis, the drug can be administered subcutaneously in 1 ml (5000 IU) twice a day. The need for this is indicated by the instructions for use attached to the preparation "Heparin". The injections, as a rule, are made in the abdomen area, in its anterolateral wall. To do this, take a thin needle and insert it deep into the fold of the skin. It is formed if the area between the thumb and forefinger is clamped between the abdomen and the navel. Place of injection must be alternated. In exceptional cases, injections can be done in the upper part of the hip or shoulder.

Selection of dosage

For therapeutic purposes in hospital treatment in hospitals, intravenous infusions are often prescribed. For adult patients, the dosage is 1000 IU / hour. But before installing the dropper for maximum effect it can be injected into a vein in the amount of 5000 IU. The exact dose is selected by the doctor depending on the situation and the weight of the patient.

If intravenous infusion is not possible, then the agent can be administered subcutaneously: 2 ml of the drug (which corresponds to 10,000 IU) 4 times a day. In the maximum dosage, as a rule, the drug is used up to 10 days.

The necessary amount of the drug is selected after evaluating the results of the tests. Particular attention is paid to APTT (activated partial thromboplastin time).

When the blood is transfused, the donor is usually injected with 7.5-10 thousand IU of the "Heparin" remedy.

Therapy in special cases

In acute myocardial infarction, 10-15 thousand IU intravenously are injected immediately, and then continue to use it from such a calculation that the patient on the first day received about 40,000 IU, but the exact dose is selected depending on the weight of the patient. This is necessary to ensure that the blood is folded 2.5-3 times slower. Starting from the second day, the dosage is reduced. It is important that the clotting time is 1.5-2 times higher than normal. Treatment with this drug lasts up to 8 days. To cancel it daily, the dose is reduced by 5-10 thousand IU, but the intervals between injections do not increase. After the abolition, they switch to anticoagulants of indirect action. It can be such means, as "Fenilin", "Neodikumarin" and others.

Acute arterial or venous obstruction also requires a special approach. For treatment, intravenous heparin is prescribed for 3-5 days at a dosage of 400-450 IU for each kg of the patient's weight. That is, a patient of medium build and height should get about 30-40 thousand IU of the drug "Heparin" per day. Then they switch to a fractional administration, but the dosage increases to 600 IU / kg, with 100 IU / kg per injection. Treatment can last up to 16 days. A few days before the drug cancellation, its amount is gradually reduced. Treatment continues with the use of indirect anticoagulants.

special instructions

Despite the fact that some people talk about the possibility of intramuscular injection of the drug, this is not recommended because of the frequent formation of hematomas at the injection site. To dilute the preparation, use a solution of 0.9% NaCl.

It is also important to know that during treatment with Heparin, you should not do any intramuscular injections and perform organ biopsy. When it is used, it is necessary to monitor the state of hemocoagulation. In the first week of therapy, the blood is checked every two days, since the second week it can be done every 3 days.

Although the agent does not penetrate into breast milk, it is advisable to stop lactation during therapy. It was found that the drug leads in some cases to spinal injuries and the development of osteoporosis. Problems begin after 2-4 weeks of taking the drug.

Separately it is worth noting that the drug solution may turn yellow, but this does not affect its pharmacological properties or the tolerability of the "Heparin" remedy. Pricks, the price of which can significantly affect the budget when it is prescribed in high dosages, can be done even at home.

Contraindications

Like any other means, you can not use the drug "Heparin" with individual intolerance. It is not prescribed for any bleeding. The exception is haemorrhages that occur with a lung infarction (expressed in the form of hemoptysis) or kidneys (accompanied by hematuria).

Contraindications also include:

- hemorrhagic diathesis and other diseases, in which blood coagulability is violated;

- increased vascular permeability, for example, with Verlhof disease;

- bacterial endocarditis ;

Bleeding in the anamnesis;

- hypoplastic and aplastic anemia, chronic and acute leukemia;

- severe violations of the liver and kidneys;

- Venous gangrene;

- acute development of an aneurysm of the heart.

Precautionary measures

In addition to direct contraindications, there is a list of situations in which it is necessary to evaluate all possible risks when taking the drug "Heparin". Injections and intravenous administration are done only in exceptional cases and under the supervision of specialists with tumoral and ulcerative lesions of the gastrointestinal tract, high blood pressure, postpartum and postoperative period, with the exception of operations on vessels.

A few words about the therapy of future mothers. Despite the fact that treatment of women in an interesting position by the means we are considering is undesirable (this can lead to the development of complications), injections of "Heparin" into the abdomen are prescribed in some cases and during pregnancy. The probability of adverse events varies from 10 to 21%. Although for normal pregnancy the risk of complications does not exceed 3.6%.

It is worth noting that the consequences of possible thromboembolism in future mothers are more dangerous for life than receiving the drug "Heparin". Pricks during pregnancy are done only under medical supervision and only in the presence of absolute indications. But the medication can cause bleeding, osteoporosis and thrombocytopenia. Through the placenta, the agent does not penetrate.

Possible analogs and reviews of patients

Often, those who are prescribed the drug "Heparin" (prick in the stomach), the price seems too high. But when using it for preventive purposes, 1 bottle can be missed for several days. Hence, the packaging, in which there are 5 bottles, can suffice for a couple of weeks. And in high doses the drug is usually used no more than 10-14 days.

Nevertheless, many people want to know from other patients whether it is worth buying this drug, they are looking for the drug "Heparin" reviews. Analogues of this medicine are also of interest to them. So, if there are problems with the coagulability of the blood, then the drug is very effective and allows you to achieve the desired therapeutic effect very quickly. This is confirmed by both physicians and their patients.

But instead, anticoagulants "Troparin", "Heparin Sandoz", "Heparin Sodium Brown", "Heparin-Ferein" and other analogues can also be prescribed. Dosage of these drugs should be selected only by the doctor, taking into account the results of the patient's tests, the state of his health and the indications for which the medicine is prescribed.

In certain cases, doctors recommend low molecular weight heparins, for example, "Fraksiparin", "Fragmin", "Cibor", "Enixum", "Fraksiparin Fort". The effect of their use, as evidenced by the reviews of patients, is almost the same as the one we are considering.