Pharmacodynamics, clinical indications, and adverse effects of heparin.

摘要: Heparins are a heterogenous group of naturally occurring glycosaminoglycans characterized by anticoagulant activity and wide range molecular weights (low weight or fractionated heparins evolving within the past two decades). Cofactors for endogenous inhibitors coagulation (antithrombin III heparin cofactor II), administration results in hypocoagulable state. Various platelet activities, including inhibition induced platelet-derived growth factors on vascular smooth muscle, also have been noted. Divorced nature, novel applications may include role atherosclerosis prevention, acceleration collateral coronary as well peripheral circulation (i.e., angiogenesis), continued (chronic) post-myocardial infarction therapy. Established indications treatment various thrombotic diseases, unstable angina, thrombosis chemoprophylaxis medical/surgical patients. The antithrombotic potential is used management related to extracorporeal circulatory assistance dialysis devices. Heparin's therapeutic postphlebitic syndrome acute myocardial (primarily adjunctively with thrombolytic agents) continues undergo evaluation; however, early data review shows favorable trends its inclusion situations that favor thrombus generation (e.g., anterior infarction). Although associated thrombocytopenia hypertransaminasemia, relatively tolerated. In small subset patients, severe ensue, which generally resolves medication withdrawal. As this class becomes better characterized, new emerge both native newer heparins.