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Heparin

Heparin
Drug information
Systematic (IUPAC) name
IUPAC namesee Heparin structure
Chemical data
Mol. mass12000 � 15000 g/mol
Bioavailabilitynil
Metabolismhepatic
Half-life1.5 hrs
Excretion?
Therapeutic considerations
Pregnancy cat C
Legal status ?
Routesi.v., s.c.

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Heparin (from Ancient Greek ηπαρ (hepar), liver), also known as unfractionated heparin, a highly-sulfated glycosaminoglycan, is widely used as an injectable anticoagulant, and has the highest negative charge density of any known biological molecule. It can also be used to form an inner anticoagulant surface on various experimental and medical devices such as test tubes and renal dialysis machines. Pharmaceutical-grade heparin is derived from mucosal tissues of slaughtered meat animals such as porcine (pig) intestine or bovine (cow) lung.

Although used principally in medicine for anticoagulation, the true physiological role in the body remains unclear, because blood anti-coagulation is achieved mostly by heparan sulfate proteoglycans derived from endothelial cells. Heparin is usually stored within the secretory granules of mast cells and released only into the vasculature at sites of tissue injury. It has been proposed that, rather than anticoagulation, the main purpose of heparin is defense at such sites against invading bacteria and other foreign materials. In addition, it is conserved across a number of widely different species, including some invertebrates that do not have a similar blood coagulation system.

Heparin Video

Here is an alert about a nationwide recall of all heparin and normal saline flushes manufactured by AM2 PAT, Inc. These pre-filled syringes are distributed under two brand names: Sierra Pre-filled and B. Braun. Some of the syringes have been found to be contaminated with Serratia marcescens, which has caused patient infections that can be serious and even fatal. All sizes and strengths of these heparin and saline flushes are being recalled. If you have any of these syringes, stop using them immediately. Quarantine them and return them to your distributor. For questions, contact the company at 919-552-9689. FDA Patient Safety News: March 2008 For more information, please see our website: www.accessdata.fda.gov
0.90 min. | 3.87 user rating

7.18 min. | 4.71 user rating
A free coagulation cascade study guide is available at coagulationcascade.blogspot.com! I'm a med student at Midwestern University's Chicago College of Osteopathic Medicine. I always hated trying to learn the coagulation pathways until I found a way that was simple enough for me to retain. [correction I wrote that plasmin helps form C3a to activate complement. While fibrin does split C3 into C3a and C3b, I believe that C3b is the subunit that goes on to initiate the membrane attack complex. C3a is a neutrophil chemotactic factor.] This video is intended to help you: 1) remember the pathways associated with Heparin and Warfarin 2) remember the tests used to asses the intrinsic and extrinsic pathways 3) remember the interaction of kallikrien with the coagulation pathway 4) become familiar with the roles of proteins C and S (also vitamin K dependent). 5) become familiar with the role of HMWK in the coagulation cascade and Bradykinin production 6) understand how plasmin is activated and inactivated 7) become familiar with the role of plasmin. 8) Appreciate the interaction of the coagulation cascade with complement through C3b If this video was a little too complex, I start the coagulation pathway from scratch in part 1. Note: Feel free to correct any mistakes I've made in the comments, or better yet, post a better video yourself. Maybe one day everyone will understand this stuff. Also, I can't guarantee the details of what I'm presenting are accurate, although I've tried <b>...</b>
7.73 min. | 5.0 user rating
The New Jersey Department of Health and the Institute for Safe Medication Practices (ISMP) have each recently warned about several different ways that dangerous mix-ups can occur between insulin and heparin. Some of these mix-ups happened when patients receiving total parenteral nutrition had insulin added to their TPN bags instead of heparin. In one case, a premature infant in the NICU had a blood glucose level of 17 mg/mL several hours after being started on a TPN infusion. Despite multiple administrations of dextrose, the hypoglycemia did not completely resolve until TPN was stopped. A later analysis showed that the fluid contained insulin, not heparin. This infant's long term outcome has not yet been determined, and ISMP describes two similar incidents where the babies died. These kinds of errors can happen other ways. For example, two patients who were not diabetic died after being injected with insulin instead of heparin during a vascular catheter flush procedure. In a different case, a nurse erroneously transcribed a verbal order to resume an insulin drip as "resume heparin drip." And in yet another case, a pharmacist entered an order for heparin 500 units into the computer as "regular insulin 500 units." ISMP says several factors contribute to these mix-ups. First, the 10 mL vials of insulin and heparin often look similar. Both insulin and heparin are typically used every day during each shift, so these similar-looking vials are often next to each other on a <b>...</b>
3.13 min. | 5.0 user rating
www.handwrittentutorials.com - This tutorial is the third in a series of three on the topic of Haemostasis. This video explores the actions of the anticoagulant drugs, Warfarin and Heparin, as well as the thrombolytic drugs, tPA and Straptokinase. For more entirely FREE tutorials and the accompanying PDFs visit http
5.15 min. | 4.95 user rating
Atrial Fibrillation/ atrial flutter, Stroke and A Fib, Heparin Therapy, Cardioversion vs. Defibrillation, Junctional Rhythms, PEA (Pulseless Electrical Activity) and its causes.
7.77 min. | 5.0 user rating
From Maryland - In a recent study, 499 Native Americans with type 2 diabetes were randomized to drug treatment aimed at achieving standard LDL targets of 100 mg/dL and systolic blood pressure of 130 mm Hg or to a more aggressive LDL target of 70 mg/dL and a SBP of 115 mm Hg. The more aggressive targets were associated with a reversal of atherosclerosis in the carotid artery and reduction in heart size. From Atlanta - With the widespread use of a second dose of mumps vaccine among school children, the incidence of mumps has fallen dramatically. However, in 2006 over 6000 cases were reported in the US. With most likely having received 2 doses of the mumps vaccine, the outbreak may have been related to waning immunity or less effectiveness against the G genotype of the virus. And finally, back to Maryland - According to the FDA, the number of estimated fatalities linked to tainted heparin may now be as high as 103 in the last 15 months. The deaths may be linked to allergic reactions and low blood pressure in response to contaminated heparin - a product used to lower the risk of blood clots. The contaminated batch is believed to have come from China and may have contained chondroitin sulfate - a compound seen in pig cartilage. For Insidermedicine in 60, I'm Dr. Susan Sharma.
1.67 min. | 3.8 user rating
Components of ZINGIBER OFFICINALE Acids: alpha-linolenic, ascorbic, aspartic, capric, caprylic, gadoleic, glutaminic, miristic, oleic, oxalic (root) Amino acids: arginine, asparagine, histidine, isoleucine, leucine, lysine, methionine, niacin, threonine, tryptophane, tyrosine, valine ( root) Minerals: aluminium, boron, chromium, cobalt, manganesium, phosphorus, silicon, zinc Ideal as anti-vomiting remedy, Dizziness when travelling, car sickness Vomits after chemotherapy , Vomits in the pregnancy, Postoperative vomits Stomach Ulcers: Its antibacterial power is ideal to avoid the formation of ulcers by eliminating the Helicobacter pylori, in Cases of Diarrhea: It has the capacity to eliminate harmful bacteria, as the Escherichia coli. In Circulatory problems, Ginger is a good resource to favor blood circulation. It helps to dissolve blood clots in the arteries and lowers the levels of cholesterol in blood. By making blood more fluid it helps to prevent a series of vascular problems: using Ginger can prevent heart attacks, angina pectoris or thrombosis, Raynaud's disease, It can constitute a natural alternative to conventional treatments. It healing can be fortified when Eaten together with onion and garlic Excellent : Against the symptoms of flu, coughs, Cold & Sinusitis A Slice of Ginger Root can be used to Treat the pain in Arthritis, Toothache, Bad breath Contraindications It can interact with certain anticoagulant medications as the heparin, it can interfere with the <b>...</b>
3.70 min. | 5.0 user rating
"What would have cost tens of thousands of dollars...can now be done for hundreds of dollars, so it's easier to fake stuff now," warns Roger Bate, resident scholar at the American Enterprise Institute (AEI) and the author of "Phake: The Deadly World of Falsified and Substandard Medicine." Counterfeit, adulterated, or otherwise compromised prescription drugs are a major problem in Africa and a growing problem in the First World, argues Bate. In recent years, counterfeiters passed off hundreds of thousands of phony Lexapro pills around the globe and in 2008 at least 149 Americans died from fake Heparin, a blood-thinning drug. All told, says Bate, the number of deaths globally from ineffective drugs ranges from 100000 to 1 million. As drug production moves to China and other developing nations where oversight is tougher to maintain and more sales take place online where provenance can be tougher to ascertain, Bate says that the most viable solution is increased vigilance on the part of drug makers, providers, and patients alike. He looks forward to a fast-approaching world in which hand-held spectrometers verify pills on the spot and praises various online-pharmacy certification programs. Referring to the classic 1949 film, "The Third Man," in which Orson Welles plays a drug counterfeiter whose watered-down penicillin in post-war Europe leads to the death of several children, Bate gives Hollywood credit for being well ahead of the curve on putting the spotlight on what he <b>...</b>
7.05 min. | 4.86 user rating
How do you manage a elderly person with Myocardial infarction ?
4.62 min. | 3.57 user rating

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Momenta Sues Teva Over Patents For Heparin - Wall Street Journal Tweet this news
Wall Street Journal---...- the world's largest generic-drug maker by sales, over patents related to the blockbuster rapid-acting -heparin- called enoxaparin. ... - Date : Thu, 02 Dec 2010 16:31:07 GMT+00:00
Around the capitol - Southgate News Herald Tweet this news
Southgate News Herald--High-profile risks associated with the globalized drug supply like the -heparin- crisis of 2007 have put American lives at risk. Among other items, the bill ... - Date : Thu, 23 Dec 2010 18:33:11 GMT+00:00
FamilyCord and Hoag Hospital Team Up for Cord Blood Storage - PR Newswire (press release) Tweet this news
PR Newswire (press release)--FamilyCord's new kit also utilizes liquid CPD anticoagulant in the collection bag, which provides up to 58% more CD34+ stem cells than using the dry -heparin- ... - Date : Tue, 21 Dec 2010 13:03:53 GMT+00:00
Oral Drug Reduces VTE Risk After Hip Replacement - MedPage Today Tweet this news
MedPage Today--Standard thromboprophylaxis for hip-replacement surgery includes low-molecular weight -heparin-, vitamin K antagonists, and mechanical interventions. ... - Date : Wed, 22 Dec 2010 22:03:09 GMT+00:00
Risks and benefits of blood thinner after caesarean birth needs study - BCM News Tweet this news
BCM News---...- 2010) -- Larger studies need to be undertaken in order to define the risks and benefits of enoxaparin - a form of the blood thinner -heparin- - in women ... - Date : Wed, 22 Dec 2010 22:05:02 GMT+00:00
Heparin-Bonded Vascular Graft Outperforms Teflon-Coated Version - Medscape Tweet this news
Medscape--November 30, 2010 (New York, New York) � A randomized multicenter trial has shown that a -heparin--bonded stretch or expandable polytetrafluoroethylene (PTFE ... - Date : Tue, 30 Nov 2010 17:51:16 GMT+00:00
Blood clot link to surgery failings - The Age Tweet this news
The Age--''Most patients having surgery benefit from [the drug] -heparin-, or stockings to try to compress their veins so they are at less of a risk of getting clots ... - Date : Mon, 20 Dec 2010 12:55:53 GMT+00:00
GAO Evaluates FDA's Response to 2008 Heparin Crisis - Pharmaceutical Technology Magazine Tweet this news
Pharmaceutical Technology Magazine--During the 20 months before the crisis of contaminated -heparin- in early 2008, the US Food and Drug Administration did not inspect any Chinese -heparin- firms, ... - Date : Thu, 18 Nov 2010 05:47:57 GMT+00:00
No inspections of heparin sites in China in 20 months pre-crisis - In-PharmaTechnologist.com Tweet this news
In-PharmaTechnologist.com--In the 20 month period before the -heparin- crisis no Chinese producers were inspected by the FDA and efforts during and since have been ... - Date : Wed, 10 Nov 2010 12:03:16 GMT+00:00
Dr. Donohue: Double vision comes from autoimmune illness - Richmond Times Dispatch Tweet this news
Richmond Times Dispatch--Or anticoagulation with short-acting -heparin- can substitute for Coumadin. The -heparin- is stopped hours before the surgery and is restarted as soon as the ... - Date : Fri, 19 Nov 2010 05:07:40 GMT+00:00

Adverse reactions :
Disease states sensitive to heparin Heparin's effect in experimental models Clinical status
Adult respiratory distress syndrome Reduces cell activation and accumulation in airways, neutralizes mediators and cytotoxic cell products, and improves lung function in animal models Controlled clinical trials
Allergic encephalomyelitis Effective in animal models -
Allergic rhinitis Effects as for adult respiratory distress syndrome, although no specific nasal model has been tested Controlled clinical trial
Arthritis Inhibits cell accumulation, collagen destruction and angiogenesis Anecdotal report
Asthma As for adult respiratory distress syndrome, however it has also been shown to improve lung function in experimental models Controlled clinical trials
Cancer Inhibits tumour growth, metastasis and angiogenesis, and increases survival time in animal models Several anecdotal reports
Delayed type hypersensitivity reactions Effective in animal models -
Inflammatory bowel disease Inhibits inflammatory cell transport in general. No specific model tested Controlled clinical trials
Interstitial cystitis Effective in a human experimental model of interstitial cystitis Related molecule now used clinically
Transplant rejection Prolongs allograft survival in animal models -

Adverse reactions :
Drug molecule Effect of new drug compared to heparin Biological activities
Heparin tetrasaccharide Non-anticoagulant, non-immunogenic, orally active Anti-allergic
Pentosan polysulfate Plant derived, little anticoagulant activity, Anti-inflammatory, orally active Anti-inflammatory, anti-adhesive, anti-metastatic
Phosphomannopentanose sulfate Potent inhibitor of heparanase activity Anti-metastatic, anti-angiogenic, anti-inflammatory
Selectively chemically O-desulphated heparin Lacks anticoagulant activity Anti-inflammatory, anti-allergic, anti-adhesive

Enzymatic :
Heparinase enzyme Substrate specificity
Heparinase I GlcNS(±6S)-IdoA(2S)
Heparinase II GlcNS/Ac(±6S)-IdoA(±2S)
GlcNS/Ac(±6S)-GlcA
Heparinase III GlcNS/Ac(±6S)-GlcA/IdoA (with a preference for GlcA)

Antithrombotics (thrombolytics, anticoagulants and antiplatelet drugs) (B01)

Antiplatelet drugs
Glycoprotein IIb/IIIa inhibitorsAbciximab * Eptifibatide * Tirofiban
ADP receptor/P2Y12 inhibitorsthienopyridines (Clopidogrel, Prasugrel, Ticlopidine) * Ticagrelor
Prostaglandin analogue (PGI2)Beraprost * Prostacyclin * Iloprost * Treprostinil
COX inhibitorsAcetylsalicylic acid/Aspirin# * Aloxiprin * Carbasalate calcium * Indobufen * Triflusal
Thromboxane inhibitorsthromboxane synthase inhibitors (Dipyridamole, Picotamide) * receptor antagonist (Terutroban)
Phosphodiesterase inhibitorsCilostazol * Dipyridamole * Triflusal
OtherCloricromen * Ditazole
Anticoagulants

Antithrombotics (thrombolytics, anticoagulants and antiplatelet drugs) (B01)

Antiplatelet drugs
Glycoprotein IIb/IIIa inhibitorsAbciximab * Eptifibatide * Tirofiban
ADP receptor/P2Y12 inhibitorsthienopyridines (Clopidogrel, Prasugrel, Ticlopidine) * Ticagrelor
Prostaglandin analogue (PGI2)Beraprost * Prostacyclin * Iloprost * Treprostinil
COX inhibitorsAcetylsalicylic acid/Aspirin# * Aloxiprin * Carbasalate calcium * Indobufen * Triflusal
Thromboxane inhibitorsthromboxane synthase inhibitors (Dipyridamole, Picotamide) * receptor antagonist (Terutroban)
Phosphodiesterase inhibitorsCilostazol * Dipyridamole * Triflusal
OtherCloricromen * Ditazole
Anticoagulants
Antiplatelet drugs
Glycoprotein IIb/IIIa inhibitorsAbciximab * Eptifibatide * Tirofiban
ADP receptor/P2Y12 inhibitorsthienopyridines (Clopidogrel, Prasugrel, Ticlopidine) * Ticagrelor
Prostaglandin analogue (PGI2)Beraprost * Prostacyclin * Iloprost * Treprostinil
COX inhibitorsAcetylsalicylic acid/Aspirin# * Aloxiprin * Carbasalate calcium * Indobufen * Triflusal
Thromboxane inhibitorsthromboxane synthase inhibitors (Dipyridamole, Picotamide) * receptor antagonist (Terutroban)
Phosphodiesterase inhibitorsCilostazol * Dipyridamole * Triflusal
OtherCloricromen * Ditazole
Anticoagulants
subgroup |groupstyle=background-color: MistyRose |Vitamin K antagonists
(inhibit II, VII, IX, X) |coumarins: Acenocoumarol * Coumatetralyl * Dicoumarol * Ethyl biscoumacetate * Phenprocoumon * Warfarin 1,3-Indandiones: Clorindione * Diphenadione * Phenindione other: Tioclomarol |Factor Xa inhibitors
(with some II inhibition) |
Direct thrombin (II) inhibitors
bivalent: Hirudin (Bivalirudin, Lepirudin, Desirudin)
univalent: Argatroban * Dabigatran * Melagatran * Ximelagatran |Other |REG1 * Defibrotide * Ramatroban * Antithrombin III * Protein C (Drotrecogin alfa)
Other
REG1 * Defibrotide * Ramatroban * Antithrombin III * Protein C (Drotrecogin alfa)

Vasoprotectives (C05)

Antihemorrhoidals for topical usecorticosteroids (Hydrocortisone, Prednisolone, Betamethasone, Fluorometholone, Fluocortolone, Dexamethasone, Fluocinolone acetonide, Fluocinonide) local anesthetics (Lidocaine, Tetracaine, Benzocaine, Cinchocaine, Procaine, Oxetacaine, Pramocaine) other (Tribenoside)
Antivaricose therapyheparins or heparinoids for topical use (Organo-heparinoid, Sodium apolate, Heparin, Pentosan polysulfate) sclerosing agents for local injection (Monoethanolamine oleate, Polidocanol, Invert sugar, Sodium tetradecyl sulfate, Phenol) other (Calcium dobesilate)
Capillary stabilising agentsbioflavonoids (Rutoside, Monoxerutin, Diosmin, Troxerutin, Hidrosmin) - other (Tribenoside)

Polysaccharides: glycosaminoglycans

Unsulfated, extracellular
Sulfated, extracellularChondroitin (Chondroitin sulfate, Dermatan sulfate) * Heparan sulfate * Keratan sulfate
Sulfated, intracellularHeparin



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