Free Nursing Pharmacology Review Course – Heparin Type Medications – Section 2.7

Heparin and enoxaparin serve as critical injectable anticoagulants used for the prophylaxis and treatment of deep vein thrombosis. While enoxaparin primarily inhibits Factor 10A, heparin acts on antithrombin III to inactivate both Factors 2A and 10A. Heparin requires closer monitoring of APTT levels due to its unpredictable kinetics, whereas enoxaparin is frequently used to bridge patients onto long-term warfarin therapy. A significant clinical risk is heparin-induced thrombocytopenia (HIT), specifically Type 2, which is an immune-mediated reaction causing a dangerous drop in platelets and a paradoxical increase in clotting risk. Both medications are porcine-derived, necessitating cultural or religious considerations during prescribing. In cases of overdose, protamine serves as the specific antidote for heparin. Clinical practice favors low molecular weight heparins like enoxaparin for pregnancy, while heparin remains advantageous for patients with renal failure.