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Strengths/Mixed: (in D5W) |
1X: 1.5 mg/ml or 150 mg/ 100ml (LD soln) |
2X: 1.8 mg/ml or 360 mg/ 200 ml (MD soln) 2X: 1.8 mg.ml or 450 mg/ 250 ml (MD soln) |
Acute MI: |
ADULT |
BD: 0.25 mg/kg MD: 0.5 mg/kg/hr x 12 hrs, 0.25 mg/kg/h x 36 hrs Concomitant Rx: Steptokinase 1.5 million units over 30-60 min Continue fibrinolysis 48 hrs to Revascularization or 8 days |
HIT: |
Adult: |
Acute w or w/o Thrombosis: |
0.15 mg/kg/hr - adjust PTT 1.5-2.5 of normal |
Heart Operation: |
BD: 1 mg/kg IV |
MD: 2.5 mg/kg/hr with 50 mg in pump prime |
Target: ACT 2.5x Baseline ACT |
PTCA |
BD: 0.75 mg/kg, ACT before BD#2 |
MD: 1.75 mg/kg/hr during procedure |
BD#2: 0.3 mg/klg after 5 minutes |
MD#2: 1.75 mg/kg/hr x 4hrs if STEMI |
If Pretreated with unfractionated heparin: |
After 30 min: BD: 0.75 mg/kg |
If Pretreated with Enoxaprin: |
Full Dose (see above) |
If Pretreated with LMWH: |
NSTEMI: wait 8 hrs |
Glygoprotein IIb/IIIa inhibitor concomitant Rx not recommended |
Thrompoembolism Disorder: |
LD: 1 mg/kg MD: 0.25 mg/kg/hr until PCI then do PCI dosing |
If Pretreated with unfractionated heparin: |
Wait 30 min |
If Pretreated with Enoxaprin: |
Wait 8 hrs |
PEDI 6 mo-18 y.o. |
LD: 0.125 mg/kg MD: 0.125 mg/kg/hr - target PTT 1.5-2.5 of normal |
Dose Adustment |
CrCl < 30 ml/min: MD: 1 mg/kg/hr |
Hemodialysis: 0.25 mg/kg/hr, No Bolus Obesity: For HIT - use total body weight |
Precuations |
Bleeding Hypersensitivy Rxn Thrombus Contraindication: Defibrotide |
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