Heparin Pharmacology

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist

Education, Health & Fitness, Medicine

5 • 716 Ratings

🗓️ 6 June 2019

⏱️ 17 minutes

🔗️ Recording | iTunes | RSS

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Summary

Heparin is an interesting drug with a lot of unique clinical quirks. This drug ultimately inhibits the formation of fibrin. Fibrin is an essential component of a blood clot.

Because heparin has blood thinning effects, it is critical to assess a patient's bleed risk. Look out for other agents that may increase the risk of bleeding. Examples include; NSAIDs, antiplatelet agents, and other anticoagulants.

One classic test question about heparin that often comes up is the reversal agent. Protamine can be used to help reverse the effects of heparin.

Heparin-induced thrombocytopenia is a critical adverse effect to understand. I discuss both subtypes on the podcast and let you know what to look out for.

Rarer side effects of heparin include hyperkalemia and osteoporosis (only with long term use).

Transcript

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0:00.0	Hey all, I'm Eric Christensen, pharmacist, your host of the Real Life Pharmacology podcast.
0:06.0	Today I'm going to cover heparin, and I've got a lot to cover, so I'm going to get right into it.
0:12.1	Heprin is, I guess, classified as a blood thinner in general, but also classified as an anticoagulant.
0:20.6	So obviously its effects are thinning the blood.
0:22.9	And how it does that is through the mechanism of action
0:26.6	where it stimulates the action of antithrombin 3.
0:33.0	And antithrombin 3 is important because it inactivates thrombin.
0:39.7	And further down that cascade, that action ultimately blocks the conversion of fibrenogen to fibrin.
0:51.9	And fibrin is a very very very important component in the formation
0:57.0	activation of clots so that's how it has its anti-coagulant activity primarily it also has
1:07.0	some activity as far as factor 10a as well and a couple other clotting factors.
1:15.9	And this degree of how much it inhibits, you know, throm-in versus other clotting factors does vary a little bit, but more so when we're comparing it to an oxyparin which is lovenox which I will also cover as well here coming up in the next few weeks so bringing it back home with that mechanism of action obviously you can think about adverse effects and
1:46.9	one of the primary concerns whenever used any type of blood thinning agent is going to be blood loss
1:54.4	and bleeding. So it's going to be important monitoring parameter and all that sort of stuff.
1:59.2	So why would we use a blood thinning medication?
2:03.5	Well, obviously we're going to try to prevent blood clots in some way, shape, or form. So,
2:08.7	you know, stroke prevention, prophylaxis, DVT, PE treatment, or prophylaxis, you may see it
2:15.3	use there. It can be used in the setting of acute coronary
2:19.3	syndrome as well under certain situations. Heparin flush is also something that's important
2:27.8	that you're going to see out used in practice, and that's to maintain catheter patency and so that's to prevent basically blood clots
2:38.8	in an IV line and what's important about you know different indications and why we're going to use
2:47.0	this drug one very very important thing is dosing. And I have seen some high-risk situations
	...

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