coag

• 5000 U SQ Q8-12 (12 FOR EPIDURAL)
• 80 U/KG BOLUS
• THEN 18U/KG/HR
• WANT PTT 1.5-2.5 (NORM IS 37)
• THEN CHECK Q6 HRS

• 1 MG PER 100 UNITS OF INACTIVE HEPARIN
• (SHOULD BE 1.3)

• 2.5 MG SC QD FOR DVT PRO
• TX PE AND DVT
• 5 MG <60KG
• 7.5= 60-100KG
• 10 MG>100KG

• .4 MG/KG BOLUS MAX 44 MG
• THEN .15MG/KG/HR FOR 2-10 DAYS
• MAX 16.5 MG/HR START

• 2 MG/HR
• ICU PT .8MG
• BAD LIVER .5 MG/HR
• CHECK PTT Q2

• 5 MG PO QD TO START
• 2-3 INR

• 150 MG PO TID
• BID FOR OK RENAL
• 75MG BID FOR BAD RENALS

160-325MG PO FOR ACS P 3X NITRO

• 300-600MG PO BOLUS
• 75MG QD

• 60MG PO LOADING
• 10 MG OR 5 MG (IF<60KG) QD
• TAKE WITH ASA

250MG BID

1.5MILLION U OVER 1 HOUR FOR AMI

100MG (1.25MG/KG) OVER 3HOURS

30 U FOR 2-5 MINS

0.3-0.4UG.KG OVER 15 MINS FOR MILD BLEEDING AND Vw

Bleeding episodes 90 mcg/kg q 2hrs

Surgical same continue q 2 for 48 hrs then 2-6 (minor) but q 2 hrs (major) for 5 days

Acquired hemophilia 70-90mcg/kg q 2-3 hour till hemostasis

Intercerebral bleed (dt warfarin0 10-100mcg/kg with IV Vit K