Neonatal Intensive Care Drug Manual




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Heparin


Revision Date : 1/3/2021

Approved : DD, TC, KOH




Alert

High risk medication in A PINCH Medicines list under New South Wales Clinical Excellence Commission.

Also known as unfractionated heparin (UFH). Not equivalent to low molecular weight heparin (LMWH).

Use in consultation with haematologist for treatment of thrombosis.

Many concentrations of heparin are available. Accidental overdose can occur when multiple concentrations are kept in the unit.

In neonatal settings: recommend to store the following preparations only: heparinised saline 50 units/5 mL and heparin sodium injection ampoule 1000 units/1 mL.

DBL Heparin sodium injection in vials is not recommended in neonates as it contains benzyl alcohol. However, DBL Heparin sodium injection in ampoules does not contain benzyl alcohol.



Indication

Primary or secondary antithrombotic prophylaxis.

Maintenance of arterial and central venous catheter patency.



Action

Heparin binds to antithrombin III (ATIII), potentiating ATIII’s activity by at least 1000-fold. ATIII predominantly inactivates factor Xa and thrombin (other proteases/clotting factors to lesser degree), which in turn inhibits conversion of fibrinogen to fibrin. Also possesses anti-complementary activity, inhibiting both the classic and alternative pathways.


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Neonatal Intensive Care Drug Manual

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