• MeSH
• adhezivita trombocytů účinky léků   MeSH
• arterioskleróza farmakoterapie   MeSH
• časové faktory MeSH
• cholesterol krev   MeSH
• heparin aplikace a dávkování   terapeutické užití   MeSH
• infarkt myokardu farmakoterapie   MeSH
• klofibrát aplikace a dávkování   terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• cholesterol MeSH
• heparin MeSH
• klofibrát MeSH

The author discusses problems of less well known and less frequent complications of preventive or curative heparin administration. Published findings pertaining to this problem are supplemented by the author's clinical experience. As regards the risk of heparin induced thrombocytopenia, administration of low molecular heparins involves a smaller risk.

• MeSH
• heparin škodlivé účinky   MeSH
• lidé MeSH
• trombocytopenie chemicky indukované   diagnóza   prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• heparin MeSH

Heparin as an indirect anticoagulant is used in the clinical practice for more than 60 years. It is an effective drug, but it has limitations. To the side effects belong the heparin resistance, risk of bleeding (haemorrhage), hypersensitivity reactions and heparin-induced osteoporosis. The low-molecular-weight heparins exhibit fewer side effects, but it is still necessary to know about them.

• MeSH
• antikoagulancia škodlivé účinky   MeSH
• heparin nízkomolekulární škodlivé účinky   MeSH
• heparin škodlivé účinky   MeSH
• krvácení chemicky indukované   MeSH
• léková alergie etiologie   MeSH
• léková rezistence MeSH
• lidé MeSH
• osteoporóza chemicky indukované   MeSH
• předávkování léky MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antikoagulancia MeSH
• heparin nízkomolekulární MeSH
• heparin MeSH

Heparin induced thrombocytopenia (HIT) is the result of platelet activation and it is either nonimmunologically (type I) or immunologically mediated (type II). HIT is the most frequent drug induced immune thrombocytopenia. It is completely different from all other forms of immune thrombocytopenia, because it can be accompanied by serious thromboembolic complication because of its serious clinical consequences must be prompt and very intensive.

• MeSH
• antikoagulancia škodlivé účinky   MeSH
• heparin škodlivé účinky   MeSH
• lidé MeSH
• trombocytopenie chemicky indukované   diagnóza   patofyziologie   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antikoagulancia MeSH
• heparin MeSH

This article describes the pathogenesis, diagnostics, treatment and prevention of heparin induced thrombocytopenia (HIT). Although HIT is considered to be a hematological diagnosis, every physician who treats patients with heparin can encounter it in daily practice. It is even more probable that surgeons of any specialisation will meet with HIT patients. A section of them elude diagnostic detection. There are two forms of HIT - HIT I and HIT II. HIT I is caused by a direct pro-aggregation effect of heparin. It has no clinic significance. HIT II is an antidote mediated adverse reaction to heparin. Antidotes will generate only after the exposure to heparin. They are targeted against the platelet factor 4 and they act only at the presence of heparin. They may lead to the aggregation of thrombocytes in the vascular system (there is a decrease in thrombocyte count). This event can be accompanied by a development of venous or arterial thrombosis that can have a rapid and even fatal course. This fact clarifies the importance of HIT II diagnostics. Diagnosis of HIT II is based on recognizing of the typical decrease in thrombocyte count usually 1 day after heparin administration is initiated. Clinical manifestations are more likely in patients with already damaged endothelium. If thrombocyte count decrease is not connected with clinical manifestations, it is the so called isolated HIT II and in patients who display the signs of thrombosis, it is HIT II associated with thrombosis. The goal of this article is apart from implementing the recommendations of the 7th conference of the American Respiratory Society in real life also the exploration of the diagnostic and therapeutic limits (availability) in the Czech Republic.

• MeSH
• antikoagulancia škodlivé účinky   MeSH
• heparin škodlivé účinky   MeSH
• lidé MeSH
• trombocytopenie chemicky indukované   diagnóza   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antikoagulancia MeSH
• heparin MeSH

Heparin induced thrombocytopenia is encountered in clinical practice as type I and type II. Heparin induced thrombocytopenia type II is one of the most serious complications of heparin treatment. Its incidence is between 0.5-5% of all patients treated with heparins. Contrary to type I which is most probably caused by simple interaction of heparin with platelets, in type II factors of the immune system are involved. The laboratory diagnosis is complicated and negative, in vitro tests do not rule out the diagnosis in vivo. The latter is assessed most frequently per exclusionem when there is a marked drop of platelets associated with the clinical picture of thrombotic complications. Heparin must then be immediately discontinued and at the same time usually alternative antithrombotic treatment is necessary. Low-molecular heparins are contraindicated by the majority of authors because of possible immunological cross reactions, and coumarins are also unsuitable as drugs of first choice because of their late onset of effect and initial drop of protein C. Ideal preparations are most probably direct thrombin inhibitors (recombinant hirudin and its analogues, oligopetides). Anti-thrombocyte drugs can be used, possibly the defibrination enzyme ancrode (Arwin).

• MeSH
• antifibrinolytika škodlivé účinky   MeSH
• antikoagulancia škodlivé účinky   MeSH
• heparin škodlivé účinky   MeSH
• lidé MeSH
• trombocytopenie diagnóza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antifibrinolytika MeSH
• antikoagulancia MeSH
• heparin MeSH

BACKGROUND: Heparin resistance is relatively frequent problem in cardio surgery. We were try to determine real occurrence heparin resistance before operation. AIM OF THE STUDY: Purpose of the project--to find the real frequency of heparin resistance in patients who will undergo a cardio surgical operation. To find out the dependence between the pre-operational application of heparin and the development of heparin resistance. METHODS: We recorded pre-operative administration heparin in patients. If the dose of heparin was 5 mg/kg and more then we insert patients to the group heparin resistant. RESULTS: In our collection was heparin resistance in 203 patients from 624, it was 32.5%. Test agreement relative frequency with 22% was throw out--p < 0.001--heparin resistance in our group statistically different from 22% heparin resistance was higher than hypothesis. Heparin before operation was administrate 181 patients, which make to 29%. For administration of heparin was hypothesis of independence thrown (p < 0.001). CONCLUSION: Results of our works confirmed statistically significant occurrence of heparin resistance in patients that was administration heparin pre-operative. Heparin resistance occurred against presumption 22% in 32.5% in our group. It is statistic significant difference.

• MeSH
• antikoagulancia aplikace a dávkování   MeSH
• dospělí MeSH
• heparin aplikace a dávkování   MeSH
• kardiochirurgické výkony * MeSH
• kardiopulmonální bypass MeSH
• léková rezistence MeSH
• lidé středního věku MeSH
• lidé MeSH
• předoperační péče * MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• antikoagulancia MeSH
• heparin MeSH

Heparin-induced thrombocytopenia is a prothrombotic adverse effect induced by platelet-activating antibodies against complexes of platelet factor 4 and heparin. Diagnosis rests on a clinical assessment of disease probability and laboratory testing. In this review, I describe some approaches to the evaluation of patients with suspected heparin-induced thrombocytopenia. In conclusion I draw attention to some of the reserves in the diagnostic approaches to this potentially fatal disorder in the Czech Republic.

• MeSH
• algoritmy MeSH
• antikoagulancia terapeutické užití   MeSH
• hematologické testy MeSH
• heparin škodlivé účinky   MeSH
• lidé MeSH
• trombocytopenie chemicky indukované   diagnóza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• antikoagulancia MeSH
• heparin MeSH

• MeSH
• heparin * MeSH
• spektrofotometrie MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• heparin * MeSH

Native heparin was very effective in models of arterial and venous thrombosis as well as in a model demonstrating the effect on endothelial stability in rats. The effect on venous thrombosis was particularly prominent. The activities of LMW-heparin were about the same in all three models, the absolute effective dose against arterial thrombosis being much lower than with native heparin. A heparan sulfate-related preparation (suleparoide) was much less effective in both thrombosis models, especially in the venous one, while the activity was most specifically directed to the maintenance of endothelial stability.

• MeSH
• cévní endotel účinky léků   MeSH
• heparin nízkomolekulární farmakologie   terapeutické užití   MeSH
• heparin farmakologie   terapeutické užití   MeSH
• heparitinsulfát farmakologie   terapeutické užití   MeSH
• inbrední kmeny potkanů MeSH
• krysa rodu Rattus MeSH
• tromboflebitida farmakoterapie   MeSH
• trombóza farmakoterapie   MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• heparin nízkomolekulární MeSH
• heparin MeSH
• heparitinsulfát MeSH