Unfractionated heparin is mainlyutilized in 3 medical settings. Very low level (time) applications required forshort-term, high dose (hours) of oral anticoagulant therapy for patients withmoderate to severe bleeding primarily hemodialysis, cardiopulmonary surgery,and heart failure. For this last category, it has been shown to have apro-thrombotic effect on blood clotting. The U.S unfractionated heparin isgenerally prescribed for these indications due to its ability to thin theblood. Other applications include the treatment of rheumatic fever andinfectious mononucleosis.
In this management step, an initialoral dose of the U.S.unfractionated heparin is administered. Then, the next scheduledinfusion begins after the indicated time period. If there are no developmentsor any adverse events occur, the next scheduled infusion of unfractionatedheparin is scheduled one week following the previous one. This second step ofthe management step addresses the accumulation of the anti-a levels in thebody. In some studies, the optimal dosing regimen for unfractionated heparinhas been determined. In the evaluation process, it was found that patients withsevere and early-stage cirrhosis had to tolerate higher doses than normal. Forpatients with milder degrees of the disease, the optima unfractionated heparindose is set at approximately 4 milligrams per kilogram of body weight per day.Patients with severe and chronic hepatitis B often have to tolerate higherdoses.
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