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Anticoagulation

BrandGenericDosing
ReoPro Abciximab once daily dosing???
Navastan Argatroban Normal: 2mcg/kg/min; Hepatic: 0.5mcg/kg/min; HIT: same as NL
Aspirin Aspirin
Angiomax Bivalirudin 0.7mg/kg, then 1.75mg/kg/h
Plavix Clopidogrel Proph: 75mg PO once daily (optional loading dose of 300-600mg PO)
Fragmin Dalteparin Proph: 2500-5000 IU SC daily; Tx: 200 IU/kg SC daily (max 18000 IU); Renal Dysfunction: Monitor anti-Xa level (goal 0.5-1.5 4-6 h post)
Lovenox Enoxaparin Proph: 30mg SC Q 12 h OR 40mg SC daily (renal dys: 30mg SC daily); Tx: 1mg/kg SC Q 12 h OR 1.5 mg/kg SC daily (renal dys: 1mg/kg SC daily)
Arixtra Fondaparinux <50kg: 5mg SC once daily; 50-100kg: 7.5mg SC once daily; >100kg: 10mg SC once daily
Heparin Heparin 80 units/kg IV bolus followed by 18 units/kg/hr infusion
Refludan Lepirudin 0.15mg/kg/h IV (+/- 0.4mg/kg bolus); HIT: same
Mephyton Phytonadione 2.5-25mg PO or SC(rarely up to 50mg); may repeat in 12-24 hr PO or 6-8 hr SC if PT not satisfactory
Effient Prasugrel Proph: 60mg PO once followed by 10mg PO daily w/ASA 75-325mg daily (consider 5mg PO once daily if <60kg)
Innohep Tinzaparin No Proph dose; Tx: 175 anti-Xa IU/kg SC daily
Aggrastat Tirofiban 0.4mcg/kg/min IV for 30 min, then 0.1mcg/kg/min for 12-24 h after angioplasty/atherectomy
Coumadin Warfarin Initial: 5mg PO once daily (may start lower depending on age, debilitation, malnourished, CHF, liver disease, concomitant meds, high bleeding risk); overlap w/ UFH, LMWH, of Factor Xa inhib for at least 5 days!
Integrelin Eptifibatide IV bolus 180mcg/kg followed by 2mcg/kg/min (maximum 15 mg/hr) infusion until discharge, up to 72 h
Created by: hbush
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