All calculations must be confirmed before use. The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer

Heparin Dosing Protocols
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TRH 
1. Obtain patient’s height and weight. If weight is >130% of ideal body weight (IBW) use dosing weight for heparin dosing. Contact pharmacist for all heparin dose calculations.
  a. Dosing Weight= IBW+ (actual body weight-IBW) x 0.4 [Calculated by program]
2. Obtain PTT and INR prior to heparin therapy. If levels elevated, call MD.
3. Obtain CBC prior to heparin therapy. If PLT, HGB, HCT low contact MD.
4. Loading Dose: [Options selected below]
  -heparin 80 units/kg IV push for PE/DVT age <70
  -heparin 70 units/kg IV push PE/DVT (age >70) or TIA/CVA (max of 5000 units)
  -heparin 60 units/kg IV push ACS (max of 5000 units)
  -no bolus
5. Initial Maintenance Dose: Start heparin infusion (25,000 units/500 ml) using IV pump.
Begin immediately after loading dose. [Options selected below]
  18 units/kg/hr PE/DVT age < 70
  15 units/kg/hr CVA/TIA or PE/DVT age geq 70
  12 units/kg/hr ACS
6. Obtain PTT 6 hours after start of heparin infusion
Patient:      Location:
    Weight:      Height:
Select desired weight preference based on local protocol

Select Protocol

Standard Infusion Bag

DVT /PE Guidelines
If DVT/PE with risk factors OR CVA/TIA was chosen, please specify dosing guidelines
Initial Load: units/kg    Initial Rate: units/kg/hr
Safety option: Modify if necessary- Used for DVT/PE if selected.

Limit the maximum initial bolus to: units  
Limit the maximum initial infusion rate to: units/hr

Unstable angina / NSTEMI Guidelines
IF UA / NSTEMI selected above, Fill in the section below. 
UA / NSTEMI Limits:
Initial Load: units/kg   Initial Rate:  units/kg/hr
Max initial bolus: units.  Max initial infusion rate: units/hr
 
In general, weight based nomograms are much more likely to achieve therapeutic levels  within 48 hours. It is important to note that the most critical factor in reducing the risk of recurrent thromboembolism is reaching a therapeutic PTT within 24-48 hours. Traditional  regimens that normally begin with 1000 u/hr are less likely to achieve this goal.  
 

 

Medical Calculators - A thru Z
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Lab Values - A thru Z
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