Heparin and Nitro Compatability - page 2

I work in an ER that often transfers out cardiac patients to another local hospital (they have cath lab, we do not). I am repeatedly chastised for sending patients with heparin and nitro running... Read More

  1. by   nowplayingEDRN
    Oh, I forgot to mention. Most of our physicians are trending toward using low molecular weight heparin (Lovenox) in strad of the traditional heparin infusion. Anone have any insite of this practice?
    Originally posted by nimbex
    Okay, in our cardiac surgery, EVERYthing runs into the swan .

    In our CCU, there is a rule against running them together, unless access is a problem...

    here's the kicker though... so sorry, I can't find literature as to why, our pharmacy states it's the NTG that results in heprin degrading requiring higher doses and thus taking longer for a therapudic PTT....

    BUT.... as I said... can't find a lick of evidence to support it.

    Anyway, the hell with anyone who tries to be supperior, especially at your expense.
    All of the Medline searches I have done show an "in-body" incompatability (where heparin is less effective) not an "in-line" and only at very high doses of nitro (>300mcg/min). I cannot remember the last time I ran nitro ay greater than 150mcg/min and that was a long time ago.
  3. by   baseline
    They are compatible. Do it, and put in your earplugs.
  4. by   PerkyCardiacRN
    We run Heparing & NTG together all the time in the same line.

    As for Lovenox vs. Heparin gtt...we're probably about 50/50. All depends on the doc's preference.
  5. by   nimbex
    RNCENCCRNNREMTP, thank you for the info. Sometimes I think that pharmacy is just being difficult. We don't run NTG greater then 200mcg/min... then add either natrector, nipride, dobutamine or amrinone, based on reasons.

    thanks again.
  6. by   New CCU RN
    200mcg/min is our max as well
  7. by   healingtouchRN
    The question about Heprarin/Nitro comp. is ongoing since I finished school in 1989, I have done both ER & CCU. This is what we do, if ya can get a 2nd site or 3rd site (as needed with t-PA) well great! Or just put it a Y site, if ya'll stock these little beauties. I have seen no change in PTT's or how the nitro works with it in the same line. I think their main concern is pushing the nitro when the dye or con. sedatives are injected in the CV lab for emergency procedure. Hope this helps.