|Drug Name:||Heparin Sodium|
To OpenTear outer wrap at notch and remove solution container. Some opacity of the plastic due to moisture absorption during the sterilization process may be observed.
This is normal and does not affect the solution quality or safety.
The opacity will diminish gradually.Preparation for Administration(Use aseptic technique)Close flow control clamp of administration set.Remove cover from outlet port at bottom of container.Insert piercing pin of administration set into port with a twisting motion until the set is firmly seated.
NOTE: See full directions on administration set carton.Suspend container from hanger.Squeeze and release drip chamber to establish proper fluid level in chamber.Open flow control clamp and clear air from set.
Close clamp.Attach set to venipuncture device.If device is not indwelling, prime and make venipuncture.Regulate rate of administration with flow control clamp.WARNING: Do not use flexible container in series connections.
Heparin sodium should not be used in patients:With severe thrombocytopenia;In whom suitable blood coagulation tests — e.g., the whole blood clotting time, partial thromboplastin time, etc.— cannot be performed at appropriate intervals (this contraindication refers to full-dose heparin; there is usually no need to monitor coagulation parameters in patients receiving low-dose heparin);With an uncontrollable active bleeding state (see WARNINGS),except when this is due to disseminated intravascular coagulation.Dextrose injection without electrolytes should not be administered simultaneously with blood through the same infusion set because of the possibility that pseudoagglutination of red cells may occur.
Heparin is not intended for intramuscular use.Hypersensitivity: Patients with documented hypersensitivity to heparin should be given the drug only in clearly life-threatening situations.Hemorrhage: Hemorrhage can occur at virtually any site in patients receiving heparin.
An unexplained fall in hematocrit, fall in blood pressure or any other unexplained symptom should lead to serious consideration of a hemorrhagic event.Heparin sodium should be used with extreme caution in disease states in which there is increased danger of hemorrhage.
Some of the conditions in which increased danger of hemorrhage exists are:Cardiovascular — Subacute bacterial endocarditis.
Severe hypertension.Surgical — During and immediately following (a) spinal tap or spinal anesthesia or (b) major surgery, especially involving the brain, spinal cord or eye.Hematologic— Conditions associated with increased bleeding tendencies, such as hemophilia, thrombocytopenia, and some vascular purpuras.Gastrointestinal — Ulcerative lesions and continuous tube drainage of the stomach or small intestine.Other — Menstruation, liver disease with impaired hemostasis.Coagulation Testing: When heparin sodium is administered in therapeutic amounts, its dosage should be regulated by frequent blood coagulation tests.
If the coagulation test is unduly prolonged or if hemorrhage occurs, heparin sodium should be discontinued promptly (see OVERDOSAGE).Thrombocytopenia : Thrombocytopenia has been reported to occur in patients receiving heparin with a reported incidence of 0 to 30%.
Mild thrombocytopenia (count greater than 100,000/mm3) may remain stable or reverse even if heparin is continued. However, thrombocytopenia of any degree should be monitored closely. If the count falls below 100,000/mm3 or if recurrent thrombosis develops (see White Clot Syndrome, PRECAUTIONS), the heparin product should be discontinued.
If continued heparin therapy is essential, administration of heparin from a different organ source can be reinstituted with caution.The intravenous administration of these solutions can cause fluid and/or solute overloading resulting in dilution of serum electrolyte concentrations, overhydration, congested states or pulmonary edema.The risk of dilutional states is inversely proportional to the electrolyte concentrations of administered parenteral solutions.
The risk of solute overload causing congested states with peripheral and pulmonary edema is directly proportional to the electrolyte concentrations of such solutions.Excessive administration of potassium-free solutions may result in significant hypokalemia.Heparin Sodium contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people.
The overall prevalence of sulfite sensitivity in the general population is unknown and probably low.Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people.As the dosage of solutions of heparin sodium must be titrated to individual patient response, additive medications should not be delivered via this solution.