Quote from rnmaven
I wish I still had a hardcopy of the article on IV heparin and NTG but it's been alot of years since I read the article in the AACN journal for critical care. As I remember it, the findings were that if you run NTG and Heparin together (at the Y-site) there is a problem with obtaining accurate PTT readings. Therefore, you will see that most policies require a separate line for NTG infusions.
Here is some info on nitro and heparin:
"Lack of in vitro interaction between heparin and NTG"
American Journal of Clinical Pathology
"No direct effect of NTG on the anticoagulant effect of heparin was observed as measured by aPTT"
"The effect of simultaneous IV administration of NTG and heparin on PTT"
Military Medicine September 1995
"This study indicates no significant difference in PTT in subjects receiving these infusions via separate or SAME IV sites"
"Interaction of IV heparin and organic nitrates in acute ischemic syndromes"
AJC October 1995
"The heparin dose did not show a significant correlation to the dose of IV NTG"
"A clinical and in vitro study on the possible interaction of IV nitrates with heparin anticoagulation"
Clinical Cardiology December 1994
"Nitrates had no effect on heparin activity in vitro"
"NTG induced heparin resistance"
Military Medicine August 1994
"Results show no inhibition of heparin anticoagulation by IV NTG at clinically relevant doses"
"Effects of IV NTG on heparin dosage requirements"
AJC August 1993
"Clinically significant heparin resistance was not found"
"Assessment of the drug interaction between IV NTG and heparin"
Annals of Pharmacotherapy December 1992
"Study demonstrates a clinically insignificant interaction between NTG and heparin at NTG doses commonly used in patients"
"Absence of NTG induced heparin resistance in healthy volunteers"
European Heart Journal
"A previously described NTG induced heparin resistance could not be verified by in vitro experiments or in a randomized, double-blind, crossover trial in healthy volunteers"