헤파린 (미분획)

투여 경로

금기

• Active bleeding or severe bleeding disorders
• Severe thrombocytopenia
• Recent neurosurgery or ocular surgery
• Known hypersensitivity to heparin

이상반응

• Hemorrhage (most common)
• Heparin-induced thrombocytopenia (HIT)
• Injection site reactions (hematoma, pain)
• Hypersensitivity reactions

약물 상호작용

• Aspirin · Increased risk of bleeding due to platelet inhibition · major
• NSAIDs · Increased risk of gastrointestinal ulceration and bleeding · major
• Warfarin · Synergistic anticoagulant effect; increased bleeding risk · major
• Clopidogrel · Increased risk of bleeding · major

모니터링

• aPTT (Activated Partial Thromboplastin Time) - typically target 1.5 to 2.5 times baseline
• Platelet count
• Packed Cell Volume (PCV) and Total Protein (TP)
• Clinical signs of bleeding (mucous membranes, feces, urine)

과용량

The primary sign of overdosage is **hemorrhage** (e.g., epistaxis, hematuria, melena, petechiae). * **Mild to moderate overdose:** Discontinue heparin therapy; due to its short half-life, coagulation parameters often normalize quickly. * **Severe, life-threatening hemorrhage:** Administer **protamine sulfate** as a specific reversal agent (antidote). Administer slowly IV to avoid hypotension and anaphylactoid reactions.