Certoparin
Indications
Certoparin is used for:
Pulmonary embolism, Thromboembolism, Deep venous thrombosis
Adult Dose
Adult: IV Unstable angina; Venous thromboembolism; Peripheral arterial embolism Loading dose: 5,000 u, then 1,000-2,000 u/hr.
Prevention of re-occlusion of the coronary arteries following thrombolytic therapy in MI 5,000 u, then 1,000 u/hr w/ alteplase. SC Venous thromboembolism 15,000 u 12 hrly.
Prevention of post-op venous thromboembolism 5,000 u 2 hr before surgery, then 8-12 hrly for 7 days or until patient is ambulant. Prevention of mural thrombosis 12,500 u 12 hrly for at least 10 days.
Child Dose
Renal Dose
Administration
Contra Indications
Patients predisposed to active bleeding including thrombocytopenia, peptic ulcer disease, cerebrovascular disorders, haemorrhagic blood disorders, bacterial endocarditis, severe hypertension, oesophageal varices. Recent surgery at sites where haemorrhage would be an especial risk. Severe renal and hepatic impairment. Cerebral or subarachnoid haemorrhage, abdominal or thoracic bleeding into closed space, severe traumatic bleed, hepatic, renal, splenic or arterial injury, severe haemostatic defect, arterial thrombosis with heparin-associated thrombocytopenia. IM admin.
Precautions
Monitor platelet counts. Discontinue treatment if thrombocytopenia occurs. Hypersensitivity, elderly, pregnancy.
Pregnancy-Lactation
Interactions
Enhanced anticoagulant effect w/ other drugs affecting platelet function or the coagulation system (e.g. platelet aggregation inhibitors, thrombolytic agents, salicylates, NSAIDs, vit K antagonists, dextrans, activated protein C). Decreased anticoagulant effect w/ gyceryl trinitrate infusion. Increased risk of hyperkalaemia w/ ACE inhibitors or angiotensin II antagonists.
Adverse Effects
Side effects of Certoparin :
Slight fever, headache, chills, nausea, vomiting, constipation, epistaxis, bruising, slight haematuria, skin necrosis (SC inj), osteoporosis, alopecia. Hypersensitivity reactions include urticaria, conjunctivitis, rhinitis, asthma, angioedema and anaphylactic shock. Priapism.
Potentially Fatal: Heparin-induced thrombocytopenia with or without thrombosis; bleeding.
Mechanism of Action
Certoparin is a low molecular weight Heparin. Certoparin works by interfering with the body`s natural blood clotting mechanism. This mechanism involves a series of complex pathways. Certoparin inactivate thrombin, which plays an important role in blood clot formation. Therefore, Certoparin prevent the formation of blood clots in the body and breakdown pre-existing blood clots. Certoparin has many advantages over normal heparin. These include a more effective anticoagulant effect and reduced risk of bleeding.