Managing the hemorrhagic complications of heparin therapy.
Heparin provides a powerful therapeutic ally for the clinician challenged by patients with thromboembolic disorders. A wide range of complications, however, has been observed in patients receiving heparin for thromboembolic disorders considered to be serious or life-threatening. This article addresses the management of heparin-associated bleeding. In doing so, the author examines the factors affecting levels of heparin that could lead to inappropriate or excessive administration--namely, heparin metabolism, heparin administration, laboratory monitoring, and a major contributing complication, heparin-induced thrombocytopenia. Unfortunately, attempts to manage anti-coagulant bleeding in the presence of thrombosis can often create additional difficulties that continue to challenge the clinician.
Penner
J A
JA
Department of Medicine, Michigan State University, East Lansing.
D016903:Drug Monitoring; D006470:Hemorrhage / Q000139:chemically induced*; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects* / Q000378:metabolism / Q000627:therapeutic use*; D006801:Humans; D013921:Thrombocytopenia / Q000139:chemically induced / Q000628:therapy; D013927:Thrombosis / Q000188:drug therapy*
D006493:Heparin