Abstract
The pharmacokinetic literature regarding heparin is reviewed, and suggestions regarding the therapeutic use of this anticoagulant are provided. Various kinetic parameters for heparin have been reported, including half-life of pharmacological (anticoagulant) effects using in vitro clotting time tests, and half-life and clearance of heparin using assays of heparin activity. Heparin half-life is shorter, and clearance is greater, in patients with pulmonary emboli compared to patients with deep venous thrombosis. However, heparin infusion rates may be similar regardless of type of thromboembolic disease to achieve a given pharmacological endpoint. The difference in in vitro clotting time test responses among patients given similar amounts of heparin is a most significant variable in determining heparin dosing regimens, and makes continued monitoring of heparin dosage and the associated in vitro clotting time test response necessary for the rational use of this drug.
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