[Heparins].

Abstract

For the therapist, there is only one heparin, characterized by its anticoagulant action, but two methods of administration : intravenous and subcutaneous. Heparin is a true anticoagulant, and directly opposes fibrin formation (antithrombotic action) and potentiates the inactivation of prothrombinase ; this global action, immediately effective, makes heparin undoubtedly superior to the antivitamins K. Nevertheless, its action on thrombogenesis is incomplete : it reacts only slightly or not at all on platelet aggregation and fibrinolysis. In the treatment of phebitis, its efficacity is closely bound with its rational use : early use, continuous and sufficiently prolonged infusion, and carefully adapted dosage are the key factors. The practice of interrupted intravenous injections should be abandoned because it is illogical and dangerous. The subcutaneous method ensures a heparinotherapy in all ways closely comparable with the ideal perfusion. Accidents during heparin therapy are neither more frequent nor more serious than those of a really efficient treatment with antivitamins K. At present, heparin is our most effective weapon in the prevention of post-surgical phlebitis.