A number of serious injuries and deaths have recently been linked to the use of heparin, a blood-thinning drug that contained active pharmaceutical ingredient (API) from China. Some of the adverse side effects of this drug have included symptoms such as nausea and vomiting, shortness of breath, low blood pressure, diarrhea and abdominal pain.
The primary manufacturer of heparin is Baxter Healthcare.
What exactly is this drug and why is it causing such a stir?
Heparin is an anticoagulant (anti-clotting) medication, commonly referred to as a blood thinner. Used properly, heparin makes the anti-clotting protein in your body function better and decreases the ability of the blood to clot.
Heparin is made from pig intestines and it has been marketed in the United States since the 1930s.
It is available as a liquid and is injected intravenously. A less concentrated solution is sometimes injected into intravenous catheters. It is generally administered by a nurse or health care provider, although some patients may be instructed in injecting the medication on their own at home.
Uses of Heparin
Heparin is used to prevent and treat blood clots in the veins, arteries and lungs. These are known as thromboembolic complications; in other words, clots that travel from their site of origin through the blood stream and clog up another vessel. It is often used in the early stages of pulmonary embolisms–blood clots in the lungs.
Heparin is commonly used in certain types of surgeries, such as coronary artery bypass graft surgery. Kidney patients are also often given heparin before undergoing dialysis.
Some medical devices also are coated with heparin and some diagnostic testing products use heparin when they are manufactured.
One of the serious complications that frequently arises with heparin use is heparin-induced thrombocytopenia, a bleeding disorder. The thrombocytopenia may be the result of the development of a heparin-dependent antibody that causes platelet aggregation and release. There are two types of heparin-induced thrombocytopenia. Type I is generally mild and while it requires careful monitoring, it general doesn’t require a person to stop using heparin. Type II is more serious, usually occurring 7-10 after heparin therapy has begun. In the case of Type II, the heparin should be stopped immediately and replaced by another anticoagulant.
Structure of Heparin
Wikipedia provides the following information on the structure of heparin:
“Native heparin is a polymer with a molecular weight ranging from 3 kDa to 50 kDa, although the average molecular weight of most commercial heparin preparations is in the range of 12 kDa to 15 kDa. Heparin is a member of the glycosaminoglycan family of carbohydrates (which includes the closely-related molecule heparan sulfate) and consists of a variably-sulfated repeating disaccharide unit. The main disaccharide units that occur in heparin are shown below. The most common disaccharide unit is composed of a 2-O-sulfated iduronic acid and 6-O-sulfated, N-sulfated glucosamine, IdoA(2S)-GlcNS(6S). For example, this makes up 85% of heparins from beef lung and about 75% of those from porcine intestinal mucosa. Not shown below are the rare disaccharides containing a 3-O-sulfated glucosamine (GlcNS(3S,6S)) or a free amine group (GlcNH3+). Under physiological conditions, the ester and amide sulfate groups are deprotonated and attract positively-charged counterions to form a heparin salt. It is in this form that heparin is usually administered as an anticoagulant.
One unit of heparin (the “Howell Unit”) is an amount approximately equivalent to 0.002 mg of pure heparin, which is the quantity required to keep 1 mL of cat’s blood fluid for 24 hours at 0°C.“