Unfractionated vs low-molecular-weight heparin

[vinci_4693]

Can someone help clarify what are the indications between these 2 kinds of heparin? Thanks. Iam so confused about how to choose between two.

[atrialflutter]

Originally Posted by vinci_4693

Can someone help clarify what are the indications between these 2 kinds of heparin? Thanks. Iam so confused about how to choose between two.

Low molecular weight heparin is metabolized by the kidneys, so whenever a patient presents with ESRD, you have to avoid giving them low molecular weight heparin. It can lead to more bleeding.

[crispr]

Originally Posted by vinci_4693

Can someone help clarify what are the indications between these 2 kinds of heparin? Thanks. Iam so confused about how to choose between two.

Unfractionated heparin is safe in use for pregnancy as it is too large and negatively charged to cross placenta.
LMWH is not safe to use for pregnancy.

Unfractionated heparin has higher incidence of HIT, LMWH still has risk but is less likely.
When HIT occurs, immediately stop all heparin-based products (UNF and LMWH).

Heparin is generally given to pregnant patients with anti-phospholipid syndrome.

[texh]

- unfrac heparin is safe in renal failure.. but AVOID LMWH in renal failure

- unfrac heparin can cause HIT while with LMWH its less likely so in normal confidtions LMWH is recommended

- for pregnancy ANY heparin works as molecular weight is big it doesnt cross placental barrier (source UW)
. dont give warfarin in preg as its terotogenic