Heparin: Classification, Uses & Side Effects

Instructor: Alexandra Unfried

Alexandra earned her master's degree in nursing education and is currently a hospital supervisor/administrator.

Heparin is a medication that is used for many different disease processes. It can be given several ways and for different lengths of time. This lesson will discuss the classification of heparin as well as its uses and side effects.

The Diagnosis

Carrie has been having pain, tenderness, and redness in her right calf for several days. It has gotten worse, and her calf is now swelling and is much larger than her left calf. She decides to go the emergency room. Test results confirm that she has a deep vein thrombosis (DVT) in her right lower leg. That means she has a blood clot that is blocking circulation in her leg. The doctor tells her that she will be admitted to the hospital and started on heparin to keep the DVT stable and prevent other blood clots from forming. Carrie has many questions about what heparin is and what the side effects are.

Classification of Heparin

Heparin is an anticoagulant. It is commonly referred to as a blood thinner, which means that it helps keep the blood thin to treat and prevent blood clots from forming in the body. Heparin is a liquid medication that can be given subcutaneously (SQ), under the skin, or intravenously (IV), in the vein. The method of administration depends on the diagnosis or condition.

Example of a subcutaneous injection

Example of an intravenous injection

Uses for Heparin

Heparin has many different uses. Carrie's diagnosis of a DVT is a common use for heparin. Other uses include:

  • Myocardial infarction/acute coronary syndrome (heart attack)
  • Pulmonary embolism (PE)
  • Atrial fibrillation (irregular heartbeat)
  • Cardiopulmonary bypass for heart surgery
  • Before general surgeries
  • After hemodialysis

The mechanism of action is approximately the same for all indications, which is to thin the blood and prevent blood clots from forming. SQ use of heparin is used for non-emergent situations. Someone with a history of atrial fibrillation who has had a recurrence may need SQ heparin as supportive therapy. Usually with atrial fibrillation, the person is on a maintenance blood thinning medication at home. However, the recurrence may require extra measures to thin the blood to ensure no clots form until the heartbeat returns to normal. SQ heparin is also used before general surgeries to make sure the blood is thin enough so no blood clots form during recovery.

IV use of heparin is used for more emergent situations. A PE is a life threatening situation in which the blood clot is in the lungs and can be fatal if there is not enough blood supplied to the affected lung. During a myocardial infarction, the heart is damaged. IV heparin makes sure that the blood can still be supplied to the heart. Heparin is given to hemodialysis patients IV but not emergently. This is done each time their dialysis catheter is accessed so that it will remain functioning and not clot.

Carrie is started on IV heparin in the hospital because there is a risk that her DVT will grow larger or that she will develop another one. Once the risk has decreased, she is then given heparin SQ while the doctors start her on a medication that she can take by mouth at home. While on heparin, Carrie needs to be aware of different side effects that she will encounter.

Side Effects of Heparin

There are several common side effects that almost every person taking heparin experiences. There are also several severe side effects that are not as common but can be dangerous.

Common side effects:

  • Bleeding (e.g., from a cut or the nose)
  • Bruising or blueish colored skin
  • Mild itching of the feet
  • Mild pain, redness, warmth, or change in skin at the site of injection

Severe side effects:

  • Unusual bleeding, bleeding that will not stop, or unusual bruising
  • Severe pain, bruising, or swelling in the stomach, back, or groin
  • Nausea, vomiting, or loss of appetite
  • Increased fatigue

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