Instructions for subcutaneous administration of heparin

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Instructions for subcutaneous administration of heparin
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Materials

1 ml insulin syringe. or a 2 ml or 5 ml syringe.
1ml=5000 units.
The bottle contains 25,000 units.
In order to make 2500 units. you need to draw 0.5 ml into the syringe.
Alcohol swabs or cotton balls.
Heparin sodium (concentration we recommend, 5 ml vials, 5000 units per ml).

Method of preparation for injection

Wash your hands.
Gather all materials needed for the injection and place them in a clean area.
Wipe the top of the heparin bottle with alcohol.
Remove the cap from the needle and pull back the plunger of the syringe to the markings corresponding to the amount of heparin you will inject. The syringe is now filled only with air.
Insert the syringe needle into the center of the rubber cap of the heparin bottle.
Press the plunger of the syringe and inject air into the heparin vial. This should help with the suction of the heparin.
Hold both the heparin vial and the syringe at the same time and turn them so that the syringe is lower than the heparin vial. Be sure not to separate the syringe from the vial.
Aspirate the amount of heparin required for administration. See if there are any air bubbles. If there are air bubbles in the syringe, click them upward and press the plunger to release them.
Once you have removed all air bubbles and drawn up the exact amount of heparin needed for the injection, remove the syringe from the heparin vial.
Place the cap on the needle. You are ready for the injection.

Subcutaneous administration of heparin

Blot the injection site with alcohol. Don't rub!
Remove the cap from the needle.
Gently grab the skin into the fold.
Take a dart-type syringe and insert the needle directly into the skin at an angle of 45-90° into the subcutaneous fat layer. Place your finger on the syringe plunger. Do not remove the needle after insertion or pull back on the plunger (this prevents damage to small blood vessels, which can lead to bleeding and bruising).
Press the plunger as slowly as possible. After all the heparin has been injected, slowly withdraw the needle at the same angle at which it was inserted while releasing the skin fold. Apply light pressure to the injection site with a cotton ball for a few minutes. Do not rub the injection site. Rubbing the injection site increases the chance of bruising and bleeding. Use the patch only when necessary. The area may become irritated when the patch is removed, thereby increasing the likelihood of bruising.
Separate the needle from the syringe and throw them away separately.

Changing heparin injection sites

Choose a site for your morning heparin injection.
In the evening, use the opposite side for injection. The most preferred areas for injections are the upper and lower abdomen. If all the places on the anterior abdominal wall have been used, move on to the top of the thighs, buttocks, then to the back area. This will reduce the likelihood of large bruises and other possible complications. Don't forget to mark each injection you give on the chart. If you have any problems, contact your doctor. If you need to inject heparin into another area, you can use your thighs or buttocks, but only if there is no other place on the front abdominal wall.

Change injection sites. Never inject in the same place where you gave a previous injection or into a bruised area.

Some bruising at the injection site is normal (less than the size of a twenty-kopeck coin). If increased bruising occurs, you may apply ice before cleaning the injection site with alcohol and/or after you give yourself the injection.

Before any medical or surgical procedure, tell your doctors that you are taking heparin.

Carry a certificate in your wallet stating that you are on heparin therapy. Contact your doctor if any of the following signs occur:

Nose bleed.
Blood in urine or stool.
Excessive bleeding lasting more than 15 minutes and not controlled by direct pressure.
Unusual bruising not at the injection site.

Pharmacological properties

Most patients have a question: why is it necessary to prescribe Heparin injections? The drug is used in the form of a solution for injection, as this promotes rapid penetration of the active substance into the bloodstream and instantly slows down the process of coagulation of biological fluid.

The drug causes a moderate vasodilator effect

The drug exhibits the following effects in the body:

increases renal blood supply;
increases the tone of cerebral vessels;
slows down enzymatic activity of the brain;
reduces the rate of excess aldosterone synthesis in the adrenal glands;
promotes the activation of parathyroid hormone;
controls the level of adrenaline in the blood.

In complex therapy for patients diagnosed with coronary insufficiency, administration of the solution helps prevent the development of the following pathologies:

acute thrombosis of coronary vessels;
reducing the number of relapses of myocardial infarction;
reduction in the number of deaths after coronary heart disease.

A low dosage of the drug is used to prevent the formation of blood clots inside blood vessels and in patients after surgery. Large doses of the drug are intended for the treatment of pulmonary arterial thromboembolism or venous blockage.

Side effects

If you follow the Heparin treatment regimen, the symptoms of the disease gradually decrease, but situations arise when taking the medicine causes side effects:

allergic reaction;
migraine headaches;
osteoporosis;
dysfunctions of the digestive tract;
diarrhea;
hyperthermia;
skin rashes;
bleeding;
impaired renal function.

The most common complications of taking the medication are nausea and vomiting.

As a rule, side effects occur due to uncontrolled or prolonged use of the medication. To reduce the risk of negative effects, it is necessary to observe the dosage of the solution and adhere to the treatment regimen.

Indications for use

Patients with impaired blood clotting function are recommended to undergo a course of Heparin injections. The drug has a broad pharmacological effect, so in medicine it is used not only as an anticoagulant.

To prevent blood clotting, the drug is used during the hemodialysis procedure.

Administration of the solution is indicated in the presence of the following conditions:

progressive form of angina;
IHD in the acute phase;
prevention and treatment of thrombosis of various origins;
after operations related to pathology of the heart and blood vessels;
pathology of the valve apparatus;
inflammation of the heart valves;
blockage of the renal vein by a thrombus;
inflammatory kidney diseases;
bronchial asthma;
systemic inflammatory conditions;
cleaning of venous catheters.

Good results are obtained by using the solution for prophylactic purposes, in case of clot formation in the lumen of peripheral arteries and after surgery in the heart area.

Duration of pharmacological effect

If the solution is administered by intradermal injection into the abdominal area, the patient should know that they must be done frequently, since the pharmacological effect occurs quickly and its duration is short-lived. When the drug is administered intravenously, an almost instantaneous inhibition of blood clotting is observed, while its effect lasts up to 5 hours.

To prevent the formation of fibrin clots, the duration of action of the drug increases slightly

After an injection into the muscle, the therapeutic effect occurs after 30 minutes and lasts for 6 hours. The effect of intradermal administration occurs within 40 minutes and lasts up to 8 hours.

Pharmacodynamics

The pharmacological effect of the described drug lies primarily in the process of inhibiting the formation of fibrin. When Heparin is administered intravenously, the following effect is achieved:

increased renal blood flow;
increasing the resistance of cerebral vessels;
decreased surfactant activity in lung tissues;
decreased production of aldosterone by the adrenal cortex;
preventing the formation of blood clots in the arteries;
prevention of primary and recurrent myocardial infarctions;
prevention of cases of sudden death of the patient.

The effect of the drug when used as an injection occurs quite quickly

The use of Heparin in the form of an ointment or gel makes it possible to relieve the inflammatory process in the affected areas and achieve resorption of blood clots and skin hematomas. As a result, existing blood clots dissolve, and new ones do not form. The mechanism of action of Heparin when used topically is to inhibit thrombin synthesis, reduce platelet aggregation, and suppress hyaluronidase activity.

Important! Both forms of release of the drug have their own indications for use and contraindications. The decision to prescribe this or that drug is made solely by the doctor.

Use of the product during pregnancy

During pregnancy, women's blood viscosity may change. An increase in the number of platelets leads to increased coagulability of biological fluid. According to statistics, 10% of pregnant women are susceptible to homeostatic disorders. Therefore, some doctors prescribe Heparin during pregnancy, when the therapeutic effect of the drug is higher than the possible side effects.

Long-term use of heparin may increase a pregnant mother's risk of bleeding

According to clinical studies, the drug does not penetrate the transplacental barrier, which means it does not pose a threat to the fetus. The treatment regimen for a pregnant woman is somewhat different, for example, the calculation of the dose of the injected solution depends on the woman’s weight category, and the frequency of injections is limited to two.

The use of Heparin should be carried out under the strict supervision of specialists, since spontaneous labor may develop. In case of long-term treatment, it is recommended to take a blood test for coagulation once every two days, and with heparin therapy for more than 7 days, the test is taken once every 3 days.

The use of the medication may interfere with the distribution of calcium in the body. Thus, a pregnant woman may experience acute calcium deficiency, so along with the use of Heparin, supplements containing all the necessary microelements should be taken.

What can be replaced

An analogue of Heparin is also a solution of a drug, but from a different production.

The following solution analogues exist:

Sodium Brown.
Richter.
Frayn.

The use of these funds should be carried out after consultation with a specialist.

Thus, Heparin is a good drug for thinning the blood and preventing the development of blood clots inside blood vessels. However, during its use it is necessary to carefully monitor blood clotting parameters and follow the chosen therapeutic course.

Special Recommendations

Heparin therapy is carried out under strict control of hemocoagulation parameters. A coagulogram is carried out in the first week of treatment with the drug and immediately after surgery, the optimal number of studies is 1 time every 2-3 days. With fractional administration of the solution, a blood test is done immediately before the injection.

It is not recommended to abruptly interrupt the course of treatment with Heparin, as this may lead to the initiation of thrombus formation. Therefore, it is necessary to gradually reduce the dosage of the drug with the parallel use of indirect anticoagulants. The only exceptions are cases of individual intolerance to some components of the solution.

Despite the possibility of intramuscular injection of the solution, experts do not recommend it due to the fact that bruises form at the injection site.

Features of dosage selection

The dose of the administered solution depends on the degree of thrombosis, the severity of symptoms and the individual sensitivity of the patient to the drug. In patients, it is necessary to constantly monitor coagulogram parameters, since if the dose is incorrectly selected, the blood clotting period can significantly exceed the norm, which can lead to bleeding.

Before discontinuing the drug, the daily dosage must be reduced so that there is no increase in the intervals between injections

According to the instructions for use, the dosage of the drug is prescribed depending on the route of administration:

Intravenous drip infusions. The daily dosage is selected at the rate of 400 U/kg.
Intramuscular and subcutaneous injections. The dose of the solution should not exceed 600 units/kg per day.
Intravenous administration. Single dose – 100 units/kg.

After completing the course of Heparin therapy, anticoagulant treatment with indirect-acting drugs is prescribed, the administration of which begins one day before the first reduction in the dose of the active substance.