Heparin | Mechanism of Action, Indications, ADR’s, Contraindications

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Ninja Nerds!
In this cardiovascular pharmacology lecture, Professor Zach Murphy breaks down the pharmacology of Heparin, one of the most commonly used parenteral anticoagulants in acute care settings. This lecture covers its mechanism of action, clinical indications, and monitoring strategies with high clarity and clinical relevance.

We begin by discussing the mechanism of action of unfractionated heparin (UFH), which binds to antithrombin III and accelerates its inhibition of thrombin (factor IIa) and factor Xa, ultimately preventing fibrin clot formation. We compare this to low molecular weight heparins (LMWH)—such as enoxaparin—which have a more selective action against factor Xa.

You’ll learn the key differences between UFH and LMWH regarding administration routes, half-life, monitoring requirements (aPTT vs anti-Xa), and protamine sulfate reversal strategies. The lecture also discusses the serious complication of heparin-induced thrombocytopenia (HIT), including its pathophysiology, clinical presentation, and alternative anticoagulant options like argatroban.

Clinical indications for heparin include venous thromboembolism (VTE) treatment and prophylaxis, acute coronary syndromes, atrial fibrillation, and perioperative anticoagulation.

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