Immediate complications of therapy

Bleeding occurs even when APTT ratio within the therapeutic range but risk 4 with 4APTT ratio. Treatment: Stop heparin until APTT ratio <2.5. In life-threatening bleeding use protamine sulphate: 1mg/100iu of heparin given in preceding hour. Thrombocytopenia—Mild 5 platelets common early in heparin therapy; not significant. Severe thrombocytopenia less common (HITT); occurs 6-10d after therapy begun; may be associated thrombosis. Stop heparin. Give alternative antithrombin drug such as lep-irudin or danaparoid. Do not start warfarin until thrombocytopenia resolved.

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