Ver el código de «Unfractionated heparin»

==Background==
*Binds to and activates antithrombin which in turns inactivates factor Xa and thrombin
*Anticoagulation effect lasts up to 3hr after stopping infusion
*Must give IV (not subq) for acute thromboembolic disease
*Safe in pregnancy 
*Unpredictable anticoagulation effect
**Must monitor w/ PTT; therapeutic range is 1.5-2.5x normal value
*33% of pts develop some form of bleeding complication; 2-6% develop major bleeding

===Risk Factors for Major Bleeding Complication===
#Recent surgery or trauma
#Renal failure
#Alcoholism
#Malignancy
#Liver failure
#Concurrent use of warfarin, fibrinolytics, steroids, or antiplatelet drugs

==Treatment ==
#See:
##[[DVT]]
##[[PE]]
##[[NSTEMI]]
##[[STEMI]]

==Complications==
#Bleeding
##Treatment
###Managed according to clinical severity, NOT PTT value
####Heparin-associated bleeding is not always reflected by a supratherapeutic PTT
###Stop transfusion
###Observation alone may be appropriate in less severe cases
###Protamine
####Only indicated for major bleeding (0.2% of pts develop severe anaphylaxis)
####Give 1mg IV for every 100 units of UFH infused in the prior 3hr
####Give slowly over 1-3min; do not exceed 50mg in any 10 minute period
####Because half-life is short (7 min) may require second treatment
###Massive bleed
####Cryoprecipitate (10 U IV), then FFP (& platelets, aminocaproic acid infusion if nec) 
#Heparin-Induced Thrombocytopenia
##See [[HIT (Heparin-Induced Thrombocytopenia)]]

==See Also==
*[[Low Molecular Weight Heparin]]

==Source ==
Tintinalli

[[Category:Heme/Onc]]