Heparin dosage

Heparin is an anticoagulant that prevents the formation of blood clots. Like insulin, it is also measured in units of activity. IV heparin may be administered by standard gravity flow or electronic infusion devices. The normal adult heparinizing dosage is 20,000-40,000 units per 24 hours. In general, IV heparin is ordered in units per hour. Heparin may also be ordered by the physician to infuse at a predetermined flow rate in mL per hour. 

The heparin dosages may be calculated by the method of proportion. This is explained in the following examples. 

A physician ordered 1 liter D5W IV with heparin 40,000 U to infuse at 0.5 mL/min. What is the hourly heparin dosage ... 

Berk SI, Grunwald A, Pal S, Bodenheimer M4. Effect of intravenous nitroglycerin on heparin dosage requirements in coronary artery disease. Am J Cardol (1993) 72, 393-6. 

Initial dosage in HIT or heparin-induced thrombocytopenia and thrombosis syndrome (HITTS) Before administering argatroban, discontinue heparin therapy and obtain a baseline activated partial thromboplastin time (aPTT). The recommended initial dose of argatroban for adults without hepatic impairment is 2 mcg/kg/min administered as a continuous infusion (see table). 

Interchangeability Do not use interchangeably (unit for unit) with heparin, LMWHs, or heparinoids, as they differ in manufacturing process, anti-Xa and anti-lla activity, units, and dosage. 

Antithrombotics in the acute phase. The classical indications for heparin at hypocoagulation dosage are maintained. Low-molecular-weight he-parins can be used (reduced risk of haemorrhage). 

Heparin overdose (antidote and treatment) IV 1-1.5 mg protamine neutralizes 100 units heparin. Heparin disappears rapidly from circulation, reducing the dosage demand for protamine as time elapses. 

Recommended dosage and monitoring requirements In AMI, reperfusion has been achieved with single intravenous bolus doses of TNKase 30 to 50 mg, based on body weight. The dose of TNKase should not exceed 50 mg. Concomitant aspirin and heparin have usually been given. 

Dennis Quaid, a successful film actor and advocate for drug safety. His 12-day-old twins accidentally received a dosage of the blood thinner Heparin that was 1,000 times stronger than normal for infants. They nearly died, and Quaid sued the maker of the drug for negligence in not making pack-... 

Prophylactic enoxaparin is given subcutaneously in a dosage of 30 mg twice daily or 40 mg once daily. Full-dose enoxaparin therapy is 1 mg/kg subcutaneously every 12 hours. This corresponds to a therapeutic anti-factor Xa level of 0.5—1 unit/mL. Selected patients may be treated with enoxaparin 1.5 mg/kg once a day, with a target anti-Xa level of 1.5 units/mL. The prophylactic dose of dalteparin is 5000 units subcutaneously once a day therapeutic dosing is 200 units/kg once a day for venous disease or 120 units/kg every 12 hours for acute coronary syndrome. The use of LMW heparins is discouraged or contraindicated in patients with renal insufficiency or body weight greater than 150 kg. 

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