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27 Cards in this Set
- Front
- Back
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UFH dose for DVT prophylaxis
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5000 units SQ q8h
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UFH dose for venous thromboembolism (DVT/PE) treatment - IV
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bolus: 80 units/kg
continuous infusion: 18 units/kg/hour |
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UFH dose for venous thromboembolism (DVT/PE) treatment - SQ
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initial dose: 333 units/kg
subsequent: 250 units/SQ bid |
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UFH dose for acute coronary syndromes (ACS) and arterial thromboembolism (atrial fibrillation, mechanical valve) treatment
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bolus: 60-70 units/kg
continuous infusion: 12-15 units/kg/hour |
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UFH dose for thrombolysis for acute MI treatment
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bolus: 60 units/kg (max 4000 units)
continuous infusion: 12 units/kg/hour (max 1000 units/hour) |
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ratio of protamin to heparin needed for reversal of treatment
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1 mg of protamine per 100 units of heparin that has been given in the last 3 hours.
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enoxaparin dose for prophylaxis
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30 mg BID or 40 mg QD
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enoxaparin dose for treatment
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1 mg/kg BID or 1.5mg/kg QD
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enoxaparin dose for PCI (percutenous coronary intervention)
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0.3 mg/kg IV bolus if last dose > 8 hours ago
0.75 mg/kg IV bolus if no previous therapy |
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dalteparin dose for prophylaxis
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2500 units or 5000 units SQ once daily
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dalteparin dose for treatment
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100 units/kg SQ BID or 200 units/kg SQ QD
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tinzaparin dose for prophylaxis
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3500-4500 QD
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tinzaparin dose for treatment
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175 units/kg SQ QD
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enoxaparin dose for prophylaxis, adjusted for renal dysfunction
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30 mg QD
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enoxaparin dose for treatment, adjusted for renal dysfunction
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1 mg/kg QD
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enoxaparin dose for prophylaxis, adjusted for increased body size (>150 kg or BMI > 40)
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40 mg SQ BID
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protamine ratio for reversal of LMWH therapy
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1 mg per 1 mg or 100 units of enoxaparin given in the last 8 hours
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fondaparinux dose for prophylaxis
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2.5 mg QD
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fondaparinux dose for treatment of ACS
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2.5 mg QD
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fondaparinux dose for treatment of VTE
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5 mg (<50kg) QD
7.5 mg (50-100kg) QD 10 mg (>100kg) QD |
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argatroban typical dose
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2 ug/kg/min
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argatroban critically ill dose
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1.0 ug/kg.min
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bivalirudin dose for ACS treatment
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0.1 mg/kg bolus
0.25 mg/kg/hr infusion |
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bivalirudin dose for HIT treatment
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0.15 mg/kg/hour
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bivalirudin dose for PCI treatment
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0.75 mg/kg bolus
1.75 mg/kg/hr infusion |
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prophylaxis dosing options for medium risk patient population
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enoxaparin 40 mg SQ QD
dalteparin 2500-5000 units SQ QD UFH 5000 units SQ TID fondaparainux 2.5 mg SQ QD |
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prophylaxis dosing options for high risk patient population
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enoxaparin 30 mg SQ BID
dalteparin 5000 units QD tinzaparin 75 units/kg or 3500-4500 units SQ QD UFH 5000 units SQ TID plus IPC fondaparinux 2.5 mg SQ QD warfarin INR 2-3 (usually only for patients undergoing major orthopedic surgery) |
