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With low dosage of heparin, the risk of bleeding is sufficiently small to allow the first injection to be given as early as 2 h prior to surgery. Higher daily i. v. doses are required to prevent growth of clots. Besides bleeding, other potential adverse effects are: allergic reactions (e. g. , thrombocytopenia) and with chronic administration, reversible hair loss and osteoporosis.
Indications: pulmonary edema (added advantage of i. v. injection in left ventricular failure: immediate dilation of venous capacitance vessels preload reduction); refractoriness to thiazide diuretics, e. g. , in renal hypovolemic failure with creatinine clearance reduction (<30 mL/min); prophylaxis of acute renal hypovolemic failure; hypercalcemia.

 

Therapeutic measures include: 1. administration of atropine in high dosage to shield muscarinic acetylcholine receptors; and 2. reactivation of acetylcholinesterase by obidoxime, which successively binds to the enzyme, captures the phosphate residue by a nucleophilic attack, and then dissociates from the active center to release the enzyme from inhibition.
In terms of solubility, phospholipids are amphiphilic: the tail region containing the apolar fatty acid chains is lipophilic, the remainder – the polar head – is hydrophilic. By virtue of these properties, phospholipids aggregate spontaneously into a bilayer in an aqueous medium, their polar heads directed outwards into the aqueous medium.

 

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