Thursday, February 15, 2018

Heparin - anticoagulatory drug and its therapeutic uses


DESCRIPTION:
Heparin is an anticoagulants. It is a non-uniform mixture of straight chain mucopolysaccharides   with molecular  weight 10,000 to 20,000.
Heparin present in all tissue containing mast cell  like lung liver, intestinal mucosa.
It is produced from ox lung & pig intestinal mucosa.

MECHANISM OF ACTION:
It acts as anticoagulants. It acts indirectly by activating plasma thrombin III(which is  A III,  a serine proteniase inhibitor).
It makes complex than binds to clotting factor of the intrinsic pathway (Xa, IIa,IXa XI a, XII-a ,) & inactives them.
It is not operative extrinsic pathway.
Xa is responsible for conversion of fibrinogen to fibrin.
At higher dose it ,inhibit platelet aggregation and prolongs bleeding time.

PHARMACOLOGY:
Heparin is a large ionized molecules. So it is not absorbed orally.
 I.V dose of heparin is acts immediately (~60 min). It is anticoagulant of  choice during pregnancy.
Metabolized in liver by heparinise excreted in urine.
Half Life: 1-4 hrs.

 THERAPEUTIC USES:
Heparin is generally used for anticoagulate for the following conditions :-
Acute coronary syndrome
Atrial fibrillation
Cardiopulmonary bypass for heart surgery
Hemolfiltration
Deep vein thrombosis & Pulmonary embolism

ADVERSE EFFECTS :
Haematuria ( due to presence of blood in urine)
Thrombocytopenia (due to deficiency of platelets in the blood)


REFERENCE- Tripathi K.D. "Essentials of Medical Pharmacology", 7th Edition, page no- 617

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