{"id":57488,"date":"2024-02-27T17:46:46","date_gmt":"2024-02-27T17:46:46","guid":{"rendered":"https:\/\/medsname.com\/stanhep-25-heparin-sodium-injection\/"},"modified":"2026-05-01T10:49:14","modified_gmt":"2026-05-01T10:49:14","slug":"stanhep-25-heparin-sodium-injection","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/stanhep-25-heparin-sodium-injection\/","title":{"rendered":"Stanhep 25 Heparin Sodium Injection"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Stanhep 25?<\/h3>\n<p style=\"margin:0;\"><strong>Stanhep 25<\/strong> je 25 000 IU v 5 ml injek\u010dn\u00ed roztok nefrakcionovan\u00e9ho heparinu sodn\u00e9ho od v\u00fdrobce certifikovan\u00e9ho WHO-GMP \u2014 nep\u0159\u00edm\u00e9 parenter\u00e1ln\u00ed antikoagulans pod\u00e1van\u00e9 intraven\u00f3zn\u00ed infuz\u00ed nebo subkut\u00e1nn\u00ed injekc\u00ed v nemocni\u010dn\u00edm prost\u0159ed\u00ed. Heparin p\u016fsob\u00ed zes\u00edlen\u00edm antitrombinu, kter\u00fd n\u00e1sledn\u011b inaktivuje trombin (IIa) a faktor Xa. N\u00e1stup \u00fa\u010dinku je okam\u017eit\u00fd (p\u0159i IV pod\u00e1n\u00ed) a polo\u010das je kr\u00e1tk\u00fd (60\u201390 minut) \u2014 proto je l\u00e9kem volby, kdy\u017e je t\u0159eba rychl\u00fd n\u00e1stup, rychl\u00fd \u00fastup \u00fa\u010dinku a mo\u017enost reverze protaminem (akutn\u00ed koron\u00e1rn\u00ed syndrom, periopera\u010dn\u00ed bridging, dial\u00fdza, ren\u00e1ln\u00ed selh\u00e1n\u00ed, kde se LMWH kumuluje). D\u00e1vkov\u00e1n\u00ed je zalo\u017eeno na hmotnosti a titrov\u00e1no podle aPTT 1,5\u20132,5n\u00e1sobku v\u00fdchoz\u00ed hodnoty nebo anti-Xa 0,3\u20130,7 IU\/ml. Hlavn\u00ed \u017eivot ohro\u017euj\u00edc\u00ed komplikac\u00ed je heparinem indukovan\u00e1 trombocytopenie (HIT), imunitn\u00ed reakce obvykle se objevuj\u00edc\u00ed 5.\u201310. den. Reverze: protamin sulf\u00e1t. Tento p\u0159\u00edpravek je ur\u010den v\u00fdhradn\u011b pro nemocni\u010dn\u00ed pou\u017eit\u00ed pod l\u00e9ka\u0159sk\u00fdm dohledem \u2014 nen\u00ed k samopod\u00e1v\u00e1n\u00ed.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:0 0 22px 0;border-radius:4px;font-size:14px;\"><strong>Antikoagulans pouze pro nemocni\u010dn\u00ed IV\/SC pod\u00e1n\u00ed.<\/strong> Stanhep 25 (heparin sodn\u00fd 25 000 IU v 5 ml injek\u010dn\u00ed lahvi\u010dce) pod\u00e1vaj\u00ed vy\u0161kolen\u00ed zdravotn\u00edci pod kontrolou aPTT nebo anti-Xa. Nen\u00ed ur\u010den k ambulantn\u00edmu samopod\u00e1v\u00e1n\u00ed. Pro profylaxi nebo l\u00e9\u010dbu VTE v dom\u00e1c\u00edm prost\u0159ed\u00ed v\u011bt\u0161ina pacient\u016f nyn\u00ed dost\u00e1v\u00e1 n\u00edzkomolekul\u00e1rn\u00ed heparin (enoxaparin, dalteparin) nebo DOAC.<\/div>\n<h2 class=\"wp-block-heading\">Co je Stanhep 25?<\/h2>\n<p>Stanhep 25 je nefrakcionovan\u00fd heparin (UFH) sodn\u00fd 25 000 IU v 5 ml injek\u010dn\u00ed lahvi\u010dce od v\u00fdrobce certifikovan\u00e9ho WHO-GMP, dod\u00e1van\u00fd v balen\u00ed po 1\u201310 lahvi\u010dk\u00e1ch. UFH je prototyp parenter\u00e1ln\u00edho antikoagulans pou\u017e\u00edvan\u00e9ho v klinick\u00e9 praxi od 30. let 20. stolet\u00ed. Navzdory n\u00e1stupu LMWH a DOAC si zachov\u00e1v\u00e1 kl\u00ed\u010dov\u00e9 role tam, kde z\u00e1le\u017e\u00ed na rychl\u00e9m n\u00e1stupu, rychl\u00e9m \u00fastupu \u00fa\u010dinku a mo\u017enosti reverze protaminem.<\/p>\n<h2 class=\"wp-block-heading\">Jak heparin funguje<\/h2>\n<p>Heparin se v\u00e1\u017ee na antitrombin III prost\u0159ednictv\u00edm sv\u00e9 pentasacharidov\u00e9 sekvence a urychluje inhibici trombinu (faktor IIa) a faktoru Xa antitrombinem p\u0159ibli\u017en\u011b 1000kr\u00e1t. Nefrakcionovan\u00fd heparin (UFH) inhibuje IIa a Xa p\u0159ibli\u017en\u011b stejn\u011b; n\u00edzkomolekul\u00e1rn\u00ed hepariny (LMWH) preferen\u010dn\u011b inhibuj\u00ed Xa. N\u00e1stup \u00fa\u010dinku je okam\u017eit\u00fd p\u0159i intraven\u00f3zn\u00edm pod\u00e1n\u00ed; p\u0159i subkut\u00e1nn\u00edm pod\u00e1n\u00ed je n\u00e1stup za 20-30 minut. Polo\u010das v plazm\u011b je 60-90 minut, z\u00e1vis\u00ed na d\u00e1vce, co\u017e umo\u017e\u0148uje rychl\u00e9 ukon\u010den\u00ed \u00fa\u010dinku.<\/p>\n<h2 class=\"wp-block-heading\">Schv\u00e1len\u00e9 indikace<\/h2>\n<ul>\n<li><strong>Akutn\u00ed koron\u00e1rn\u00ed syndrom (NSTEMI \/ nestabiln\u00ed angina pectoris, STEMI)<\/strong> \u2014 s antiagreganci\u00ed a PCI<\/li>\n<li><strong>Akutn\u00ed \u017eiln\u00ed tromboembolie (DVT, PE)<\/strong> \u2014 zejm\u00e9na kdy\u017e nen\u00ed vhodn\u00fd LMWH (t\u011b\u017ek\u00e9 selh\u00e1n\u00ed ledvin, pl\u00e1novan\u00e9 v\u00fdkony)<\/li>\n<li><strong>Periopera\u010dn\u00ed bridging<\/strong> u pacient\u016f na dlouhodob\u00e9 antikoagula\u010dn\u00ed l\u00e9\u010db\u011b podstupuj\u00edc\u00edch chirurgick\u00fd v\u00fdkon<\/li>\n<li><strong>Mimot\u011bln\u00ed ob\u011bh p\u0159i kardiopulmon\u00e1ln\u00edm bypassu a ECMO<\/strong><\/li>\n<li><strong>N\u00e1hrada ledvinn\u00fdch funkc\u00ed (CRRT) a hemodial\u00fdza<\/strong> \u2014 antikoagulace obvodu<\/li>\n<li><strong>Pr\u016fchodnost kat\u00e9tru a kanyly<\/strong> \u2014 n\u00edzkod\u00e1vkov\u00fd v\u00fdplach (samostatn\u00e9 p\u0159\u00edpravky s ni\u017e\u0161\u00ed koncentrac\u00ed)<\/li>\n<li><strong>Bridging p\u0159i kardioverzi fibrilace s\u00edn\u00ed<\/strong><\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed a monitorov\u00e1n\u00ed<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:0 0 22px 0;font-size:14px;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;text-align:left;\">Indikace<\/th>\n<th style=\"padding:8px;text-align:left;\">Nasycovac\u00ed d\u00e1vka<\/th>\n<th style=\"padding:8px;text-align:left;\">Udr\u017eovac\u00ed d\u00e1vka<\/th>\n<th style=\"padding:8px;text-align:left;\">C\u00edlov\u00e1 d\u00e1vka<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:8px;\">Akutn\u00ed VTE (l\u00e9\u010dba)<\/td>\n<td style=\"padding:8px;\">80 IU\/kg IV bolus<\/td>\n<td style=\"padding:8px;\">18 IU\/kg\/h IV infuze<\/td>\n<td style=\"padding:8px;\">aPTT 1,5\u20132,5\u00d7 v\u00fdchoz\u00ed hodnota<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;\">ACS<\/td>\n<td style=\"padding:8px;\">60 IU\/kg (max. 4 000 IU)<\/td>\n<td style=\"padding:8px;\">12 IU\/kg\/h (max. 1 000 IU\/h)<\/td>\n<td style=\"padding:8px;\">aPTT 50\u201370 sek<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:8px;\">SC profylaxe<\/td>\n<td style=\"padding:8px;\">\u2014<\/td>\n<td style=\"padding:8px;\">5 000 IU SC ka\u017ed\u00fdch 8\u201312 hod<\/td>\n<td style=\"padding:8px;\">Rutinn\u00ed monitorov\u00e1n\u00ed se nevy\u017eaduje<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;\">Kardiopulmon\u00e1ln\u00ed bypass<\/td>\n<td style=\"padding:8px;\">300\u2013400 IU\/kg IV<\/td>\n<td style=\"padding:8px;\">Red\u00f3za k udr\u017een\u00ed ACT<\/td>\n<td style=\"padding:8px;\">ACT &gt;480 sek<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Monitorujte aPTT nebo anti-Xa (0,3\u20130,7 IU\/ml) ka\u017ed\u00fdch 6 hodin po zah\u00e1jen\u00ed l\u00e9\u010dby nebo zm\u011bn\u011b d\u00e1vky, pot\u00e9 denn\u011b po stabilizaci. Zkontrolujte v\u00fdchoz\u00ed hodnoty FBC, PT, aPTT, fibrinogenu, ren\u00e1ln\u00ed a jatern\u00ed funkce.<\/p>\n<h2 class=\"wp-block-heading\">Heparinem indukovan\u00e1 trombocytopenie (HIT)<\/h2>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:0 0 22px 0;border-radius:4px;font-size:14px;\"><strong>Podez\u0159en\u00ed na HIT<\/strong> pokud po\u010det trombocyt\u016f poklesne &gt;50 % oproti v\u00fdchoz\u00ed hodnot\u011b (nebo na &lt;100\u00d710<sup>9<\/sup>\/l), typicky 5.\u201310. den pod\u00e1v\u00e1n\u00ed heparinu (nebo d\u0159\u00edve p\u0159i p\u0159edchoz\u00ed expozici heparinu). HIT je paradoxn\u00ed protrombotick\u00e1 imunitn\u00ed reakce (protil\u00e1tky proti PF4\/heparinu) a nese 30\u201350% riziko tromb\u00f3zy. Postup: OKAM\u017dIT\u011a USTAVTE ve\u0161ker\u00fd heparin v\u010detn\u011b v\u00fdplach\u016f, VYH\u00ddBEJTE SE warfarinu, dokud se neobnov\u00ed trombocyty, a zahajte neheparinov\u00e9 antikoagulans (argatroban, danaparoid, fondaparinux nebo bivalirudin). Potvr\u010fte anti-PF4 ELISA a testem uvoln\u011bn\u00ed serotoninu. Sk\u00f3re 4Ts ur\u010duje klinickou pravd\u011bpodobnost.<\/div>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<ul>\n<li>Krv\u00e1cen\u00ed (v\u00fdskyt z\u00e1va\u017en\u00e9ho krv\u00e1cen\u00ed ~5 % p\u0159i terapeutick\u00e9 intraven\u00f3zn\u00ed aplikaci heparinu)<\/li>\n<li>Heparinem indukovan\u00e1 trombocytopenie (HIT) \u2014 typ II, imun\u011b zprost\u0159edkovan\u00e1, \u017eivot ohro\u017euj\u00edc\u00ed<\/li>\n<li>M\u00edrn\u00fd benign\u00ed pokles trombocyt\u016f (HIT typ I, neimunitn\u00ed, p\u0159echodn\u00fd)<\/li>\n<li>Hyperkalemie (suprese aldosteronu, zejm\u00e9na u diabetu a ren\u00e1ln\u00edho selh\u00e1n\u00ed)<\/li>\n<li>Osteopor\u00f3za p\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed &gt;3 m\u011bs\u00edce<\/li>\n<li>Pohmo\u017ed\u011bniny\/hematom v m\u00edst\u011b vpichu (subkut\u00e1nn\u00ed pod\u00e1n\u00ed)<\/li>\n<li>P\u0159ecitliv\u011blostn\u00ed reakce, vz\u00e1cn\u011b anafylaxe<\/li>\n<li>Zv\u00fd\u0161en\u00ed jatern\u00edch test\u016f<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace<\/h2>\n<ul>\n<li>Aktivn\u00ed masivn\u00ed krv\u00e1cen\u00ed<\/li>\n<li>Zn\u00e1m\u00e1 HIT nebo anamn\u00e9za HIT (pou\u017eijte neheparinov\u00fd antikoagulant)<\/li>\n<li>T\u011b\u017ek\u00e1 trombocytopenie (trombocyty &lt;50\u00d710<sup>9<\/sup>\/l)<\/li>\n<li>T\u011b\u017ek\u00e1 nekontrolovan\u00e1 hypertenze<\/li>\n<li>Ned\u00e1vn\u00fd intrakrani\u00e1ln\u00ed, o\u010dn\u00ed nebo rozs\u00e1hl\u00fd chirurgick\u00fd v\u00fdkon s rizikem krv\u00e1cen\u00ed<\/li>\n<li>Peptick\u00fd v\u0159ed s aktivn\u00edm krv\u00e1cen\u00edm, j\u00edcnov\u00e9 varixy<\/li>\n<li>P\u0159ecitliv\u011blost na heparin nebo vep\u0159ov\u00e9 produkty<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>Jin\u00e9 antikoagulancia\/antiagregancia<\/strong> (warfarin, DOAC, aspirin, klopidogrel, NSAID, fibrinolytika) \u2014 aditivn\u00ed riziko krv\u00e1cen\u00ed; kombinujte pouze p\u0159i klinick\u00e9 indikaci pod odborn\u00fdm dohledem.<\/li>\n<li><strong>Intraven\u00f3zn\u00ed infuze glyceryltrinitr\u00e1tu<\/strong> \u2014 m\u016f\u017ee sn\u00ed\u017eit \u00fa\u010dinek heparinu; monitorov\u00e1n\u00ed aPTT jako obvykle.<\/li>\n<li><strong>SSRI\/SNRI<\/strong> \u2014 m\u00edrn\u00e9 aditivn\u00ed riziko krv\u00e1cen\u00ed.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Reverze: Protamin sulf\u00e1t<\/h2>\n<p>P\u0159i z\u00e1va\u017en\u00e9m krv\u00e1cen\u00ed nebo p\u0159ed pohotovostn\u00ed reverz\u00ed neutralizuje protamin sulf\u00e1t heparin: 1 mg protaminu na 100 IU heparinu podan\u00e9ho v p\u0159edchoz\u00edch 2-3 hodin\u00e1ch, pomal\u00e9 IV pod\u00e1n\u00ed (max. 50 mg b\u011bhem 10 minut) k prevenci hypotenze a anafylaktoidn\u00edch reakc\u00ed. Maxim\u00e1ln\u00ed jednor\u00e1zov\u00e1 d\u00e1vka 50 mg; kontrolovat aPTT po 5-15 minut\u00e1ch. Vy\u0161\u0161\u00ed riziko reakce na protamin u pacient\u016f s p\u0159edchoz\u00ed expozic\u00ed NPH inzul\u00ednu, alergi\u00ed na ryby nebo po vasektomii.<\/p>\n<h2 class=\"wp-block-heading\">T\u011bhotenstv\u00ed a kojen\u00ed<\/h2>\n<p>Heparin a LMWH nep\u0159estupuj\u00ed placentu a jsou antikoagulancii volby v t\u011bhotenstv\u00ed. LMWH je preferov\u00e1n pro ambulantn\u00ed pou\u017eit\u00ed. Kojen\u00ed: heparin se nevylu\u010duje do mate\u0159sk\u00e9ho ml\u00e9ka (velk\u00e1 molekula) \u2014 bezpe\u010dn\u00fd.<\/p>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Stanhep 25 skladujte p\u0159i teplot\u011b pod 25\u00b0C, nezmrazujte. Po otev\u0159en\u00ed lahvi\u010dky dodr\u017eujte institucion\u00e1ln\u00ed steriln\u00ed protokoly. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Mohu pou\u017e\u00edvat Stanhep 25 doma?<\/h3>\n<p>Ne. Stanhep 25 je vysokod\u00e1vkovan\u00e1 multid\u00e1vkov\u00e1 lahvi\u010dka (25 000 IU\/5 mL) ur\u010den\u00e1 pro nemocni\u010dn\u00ed IV infuze nebo SC pod\u00e1v\u00e1n\u00ed hospitalizovan\u00fdm pacient\u016fm pod kontrolou aPTT nebo anti-Xa. Dom\u00e1c\u00ed antikoagulace obvykle zahrnuje LMWH (enoxaparin, dalteparin) nebo DOAC.<\/p>\n<h3 class=\"wp-block-heading\">Jak\u00fd je rozd\u00edl mezi heparinem a LMWH?<\/h3>\n<p>Nefrakcionovan\u00fd heparin (UFH) je heterogenn\u00ed sm\u011bs rovnom\u011brn\u011b inhibuj\u00edc\u00ed IIa a Xa, s kr\u00e1tk\u00fdm polo\u010dasem a monitorov\u00e1n\u00edm aPTT. LMWH (enoxaparin, dalteparin) jsou men\u0161\u00ed molekuly, preferen\u010dn\u011b inhibuj\u00ed Xa, maj\u00ed del\u0161\u00ed p\u0159edv\u00eddateln\u00fd polo\u010das, lze je pod\u00e1vat subkut\u00e1nn\u011b bez monitorov\u00e1n\u00ed u v\u011bt\u0161iny pacient\u016f a jsou prvn\u00ed volbou pro ambulantn\u00ed l\u00e9\u010dbu. UFH je preferov\u00e1n, kdy\u017e je d\u016fle\u017eit\u00fd rychl\u00fd n\u00e1stup \u00fa\u010dinku, t\u011b\u017ek\u00e9 ren\u00e1ln\u00ed selh\u00e1n\u00ed nebo mo\u017enost reverze protaminem.<\/p>\n<h3 class=\"wp-block-heading\">Co je HIT a jak se l\u00e9\u010d\u00ed?<\/h3>\n<p>Heparinem indukovan\u00e1 trombocytopenie je imunitn\u00ed reakce (protil\u00e1tky proti PF4\/heparinu) obvykle mezi 5.-10. dnem pod\u00e1v\u00e1n\u00ed heparinu, zp\u016fsobuj\u00edc\u00ed paradoxn\u00ed protrombotick\u00fd stav. P\u0159eru\u0161te ve\u0161ker\u00fd heparin (v\u010detn\u011b v\u00fdplach\u016f), vyhn\u011bte se warfarinu do obnoven\u00ed trombocyt\u016f a zahajte neheparinov\u00e9 antikoagulans (argatroban, danaparoid, fondaparinux nebo bivalirudin). Potvr\u010fte anti-PF4 ELISA a serotonin release testem.<\/p>\n<h3 class=\"wp-block-heading\">Jak se reverzuje heparin?<\/h3>\n<p>Protamin sulf\u00e1t. 1 mg na 100 IU heparinu podan\u00e9ho v p\u0159edchoz\u00edch 2-3 hodin\u00e1ch, pomal\u00e9 IV pod\u00e1n\u00ed. Maxim\u00e1ln\u00ed jednor\u00e1zov\u00e1 d\u00e1vka 50 mg. Kontrola aPTT po 5-15 minut\u00e1ch.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d monitorovat aPTT?<\/h3>\n<p>D\u00e1vkov\u00e1 odpov\u011b\u010f UFH je nep\u0159edv\u00eddateln\u00e1 kv\u016fli variabiln\u00ed vazb\u011b na plazmatick\u00e9 proteiny. aPTT odr\u00e1\u017e\u00ed antikoagulaci vnit\u0159n\u00ed dr\u00e1hy; c\u00edlem je 1,5-2,5\u00d7 baz\u00e1ln\u00ed hodnoty (obvykle 50-70 sekund) pro terapeutickou antikoagulaci. Anti-Xa (0,3-0,7 IU\/ml) je alternativn\u00ed c\u00edl tam, kde je dostupn\u00fd.<\/p>\n<h3 class=\"wp-block-heading\">Je heparin bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed?<\/h3>\n<p>Ano \u2014 heparin (a LMWH) nep\u0159ech\u00e1z\u00ed placentou a jsou antikoagulancii volby, kdy\u017e je v t\u011bhotenstv\u00ed pot\u0159eba antikoagulace. Warfarin je teratogenn\u00ed; u DOAC chyb\u00ed data pro t\u011bhotenstv\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">M\u016f\u017ee heparin zp\u016fsobit hyperkal\u00e9mii?<\/h3>\n<p>Ano \u2014 zejm\u00e9na u diabetu a ren\u00e1ln\u00edho selh\u00e1n\u00ed kv\u016fli supresi aldosteronu. Kontrolujte drasl\u00edk na za\u010d\u00e1tku a p\u0159i dlouhodob\u00e9 terapii.<\/p>\n<h3 class=\"wp-block-heading\">Co kdy\u017e d\u00edt\u011b n\u00e1hodou spolkne lahvi\u010dku s heparinem?<\/h3>\n<p>Heparin se peror\u00e1ln\u011b nevst\u0159eb\u00e1v\u00e1 \u2014 po\u017eit\u00ed \u00fasty je z hlediska antikoagulace v podstat\u011b ne\u0161kodn\u00e9. P\u0159esto d\u00edt\u011b dopravte na pohotovost k vy\u0161et\u0159en\u00ed. Parenter\u00e1ln\u00ed expozice je jin\u00e1 z\u00e1le\u017eitost.<\/p>\n<h3 class=\"wp-block-heading\">Jak se heparin pou\u017e\u00edv\u00e1 b\u011bhem dial\u00fdzy?<\/h3>\n<p>Kontinu\u00e1ln\u00ed infuze nebo bolusov\u00e9 d\u00e1vkov\u00e1n\u00ed do dialyza\u010dn\u00edho okruhu zabra\u0148uje sr\u00e1\u017een\u00ed v mimot\u011bln\u00edm syst\u00e9mu. D\u00e1vky se \u0159\u00edd\u00ed jednotkov\u00fdm protokolem; b\u011bhem procedury lze monitorovat ACT nebo aPTT.<\/p>\n<h3 class=\"wp-block-heading\">Kde lze koupit Stanhep 25 online?<\/h3>\n<p>Stanhep 25 (25 000 IU na 5 ml lahvi\u010dku, 1\u201310 lahvi\u010dek) m\u016f\u017eete koupit na MedsBase s diskr\u00e9tn\u00edm balen\u00edm a celosv\u011btovou dopravou. Toto je parenter\u00e1ln\u00ed produkt pro nemocni\u010dn\u00ed pou\u017eit\u00ed \u2014 mus\u00ed b\u00fdt pod\u00e1v\u00e1n vy\u0161kolen\u00edmi kliniky.<\/p>\n<h2 class=\"wp-block-heading\">Jin\u00e1 antikoagulancia a antiagregancia<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/warf\/\">Warf \u2014 Warfarin 1\/2\/5 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/waf-5\/\">Waf-5 \u2014 Warfarin 5 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/uniwarfin\/\">Uniwarfin \u2014 Warfarin 5 mg (Unichem)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/xarelto-20\/\">Xarelto 20 \u2014 Rivaroxaban 20 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/eliquis\/\">Eliquis \u2014 Apixaban 2,5\/5 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/plavix\/\">Plavix \u2014 Clopidogrel 75 mg (Sanofi)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/anti-coagulants\/\"><strong>Prohl\u00e9dnout v\u0161echny antikoagulancia a antiagregancia<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Nefrakcionovan\u00fd heparin je parenter\u00e1ln\u00ed antikoagulans pod\u00e1van\u00fd v nemocnici, kter\u00fd vy\u017eaduje laboratorn\u00ed monitorov\u00e1n\u00ed (aPTT nebo anti-Xa) a klinick\u00e9 sledov\u00e1n\u00ed kv\u016fli HIT. Nen\u00ed ur\u010den k samopod\u00e1v\u00e1n\u00ed. Pou\u017e\u00edvejte pouze pod l\u00e9ka\u0159sk\u00fdm dohledem s monitorov\u00e1n\u00edm po\u010dtu trombocyt\u016f a aPTT podle institucion\u00e1ln\u00edho protokolu.<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>Obecn\u00e9 zdrav\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tenovate-clobetasol-cream\/\">Tenovate Clobetasol kr\u00e9m<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/roliten\/\">Roliten<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/monolith\/\">Monolith<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zenflox-eye-drops\/\">Zenflox o\u010dn\u00ed kapky<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/iverintas-dt-12\/\">Iverintas DT-12<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>\u2705 Zabra\u0148uje vzniku krevn\u00edch sra\u017eenin<br \/>\n\u2705 Sni\u017euje riziko sr\u00e1\u017een\u00ed krve<br \/>\n\u2705 L\u00e9\u010d\u00ed tromb\u00f3zu<br \/>\n\u2705 Minimalizuje riziko embolie<br \/>\n\u2705 Zlep\u0161uje pr\u016ftok krve<\/p>\n<p>Stanhep 25 obsahuje heparin sodn\u00fd.<\/p>","protected":false},"featured_media":57489,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3635,3141,3342],"product_tag":[4311,4312],"class_list":{"0":"post-57488","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-anti-coagulants","7":"product_cat-category-overview","8":"product_cat-general-health","9":"product_tag-heparin-sodium","10":"product_tag-stanhep","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/57488","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=57488"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/57489"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=57488"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=57488"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=57488"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=57488"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}