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» Home » CAD » Cardiology » Peripheral vascular disease(PVD) » Deep vein thrombosis
Background
Epidemiology
Anatomy
Pathophysiology
Etiology
Genetics
Prognostic Factors
Clinical History
Physical Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
Medication
After 5-10 days of initial treatment:
≤60kg:30mg orally every day >60kg:60mg orally every day
Dose Adjustments
Renal impairment (PE/DVT)
15-50ml/min-30mg orally every day
>50ml/min-No dosage adjustment needed
Renal impairment (Atrial fibrillation)
CrCl<15ml/min: No data available
CrCl 15-50ml/min:30mg orally every
day
CrCl>50-95ml/min: Dosage adjustment not necessary
CrCl>95ml/min: Not recommended
indicated for Deep vein thrombosis after Hip replacement surgery:
Beginning of the preoperative period (the evening before surgery; allow approximately 24 hours between doses)
5000 IU subcutaneously every 10-14 hours before surgery
5000 IU subcutaneous every 4-8 hours after surgery
5000 IU subcutaneous during the postoperative period administer once a day
• Day of surgery-preoperative start
Subcutaneous administration of 2500 international units within two hours of surgery
2500 international units subcutaneously 4 to 8 hours after surgery or later if hemostasis has not been achieved
Allow a minimum of 6 hours between this dose and the dose to be given on postoperative day 1, and adjust the timing of the dose on postoperative day one accordingly. Five thousand international units subcutaneously once a day during the postoperative period
• Postoperative period
2500 international units subcutaneously 4 to 8 hours after surgery or later if hemostasis has not been established; allow a minimum of 6 hours between this dosage and the dose to be administered on postoperative day 1 and alter the scheduling of the dose on postoperative day 1 appropriately 5000 international units subcutaneously once daily during the postoperative period
Therapy duration:5 to 10days after surgery
Deep vein thrombosis after abdominal surgery:
• Moderate thromboembolic risk:
2500 international units subcutaneously once a day, beginning 1 to 2 hours before surgery and continued once a day postoperatively.
• High thromboembolic risk:
may be administered as a subcutaneous injection the evening before surgery and once a day postoperatively at a dose of 5000 IU per injection or as two injections of 2500 IU, each given 1 to 2 hours apart before surgery, followed by a daily injection of 5000 IU postoperatively
Therapy duration:5-10days
Prophylaxis
7500 units subcutaneous every 12 hours, OR
5000 units subcutaneous every 8-12hours
Treatment
Intravenous bolus of 80 units/kg, following continuous infusion of about 18 units/kg in hour, OR
subcutaneous injection 250 units/kg, following 250 units/kg for every 12 hours
5000 units Intravenous bolus, following continuous infusion of 1300 units/hr, OR
Dosing considerations
There are a number of concentrations available; caution is necessary to prevent the medication errors
Indicated for Deep Vein Thrombosis – Prophylaxis
150 mg orally two times a day
Note: If required, anticoagulant activity can be evaluated using aPTT or ECT instead of INR, although typically the measurement of anticoagulant activity is unnecessary with this medication
Prevention of Thromboembolism in Atrial Fibrillation
150 mg orally two times a day
Note: If required, anticoagulant activity can be evaluated using aPTT or ECT instead of INR, although typically the measurement of anticoagulant activity is unnecessary with this medication
Deep Vein Thrombosis or Pulmonary Embolism as Prophylaxis Following Hip Replacement Surgery
The recommended dosing regimen for this medication is to administer 110 mg orally 1-4 hours following surgery and after hemostasis has been achieved. Subsequently, the patient should take 220 mg orally one time a day for a duration of 28-35 days
Note: In the event that this medication is not administered on the day of surgery, treatment should begin with 220 mg orally one time a day after hemostasis has been established
Indicated for prophylactic treatment of deep vein thrombosis in patients who will undergo elective hip replacement surgery
Initially, 15 mg subcutaneously 5-15 minutes before surgery (only after regional anesthesia)
Maintain the dose at 15 mg subcutaneously every 12 hours
Carry out the evaluation risk of the bleeding disorder before drug administration
The product is discontinued in the United States
For Patients with standard bleeding risk:
Administer dose of 171 anti-Xa units/kg subcutaneously one time a day
Fixed dosing:
40 to 49 kg: dose of 7600 anti-Xa units subcutaneously one time daily
≥90 kg: dose of 17100 anti-Xa units subcutaneously one time daily
For Patients with increased risk for bleeding:
Administer dose of 86 anti-Xa units/kg subcutaneously each 12 hours
Fixed dosing:
40 to 49 kg: dose of 3800 anti-Xa units subcutaneously each 12 hours
≥90 kg: dose of 8550 anti-Xa units subcutaneously each 12 hours
Take initial dose of 300 mg, 200 mg and 100 mg orally on first, second and third day respectively
Indicated for Deep Vein Thrombosis
One time a day subcutaneously
The maximum dose is 3000 IU
Indicated for Deep vein thrombosis after abdominal surgery:
• Moderate thromboembolic risk:
2500 international units subcutaneously once a day, beginning 1 to 2 hours before surgery
• High thromboembolic risk:
may be administered as a subcutaneous injection the evening before surgery and once a day postoperatively at a dose of 5000 IU per injection
Indicated for Deep vein thrombosis after Hip replacement surgery:
• Day of surgery-preoperative start
Subcutaneous administration of 2500 international units within two hours of surgery
• Postoperative period
2500 international units subcutaneously 4 to 8 hours after surgery thereafter 5000IU every day
Future Trends
References
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» Home » CAD » Cardiology » Peripheral vascular disease(PVD) » Deep vein thrombosis
After 5-10 days of initial treatment:
≤60kg:30mg orally every day >60kg:60mg orally every day
Dose Adjustments
Renal impairment (PE/DVT)
15-50ml/min-30mg orally every day
>50ml/min-No dosage adjustment needed
Renal impairment (Atrial fibrillation)
CrCl<15ml/min: No data available
CrCl 15-50ml/min:30mg orally every
day
CrCl>50-95ml/min: Dosage adjustment not necessary
CrCl>95ml/min: Not recommended
indicated for Deep vein thrombosis after Hip replacement surgery:
Beginning of the preoperative period (the evening before surgery; allow approximately 24 hours between doses)
5000 IU subcutaneously every 10-14 hours before surgery
5000 IU subcutaneous every 4-8 hours after surgery
5000 IU subcutaneous during the postoperative period administer once a day
• Day of surgery-preoperative start
Subcutaneous administration of 2500 international units within two hours of surgery
2500 international units subcutaneously 4 to 8 hours after surgery or later if hemostasis has not been achieved
Allow a minimum of 6 hours between this dose and the dose to be given on postoperative day 1, and adjust the timing of the dose on postoperative day one accordingly. Five thousand international units subcutaneously once a day during the postoperative period
• Postoperative period
2500 international units subcutaneously 4 to 8 hours after surgery or later if hemostasis has not been established; allow a minimum of 6 hours between this dosage and the dose to be administered on postoperative day 1 and alter the scheduling of the dose on postoperative day 1 appropriately 5000 international units subcutaneously once daily during the postoperative period
Therapy duration:5 to 10days after surgery
Deep vein thrombosis after abdominal surgery:
• Moderate thromboembolic risk:
2500 international units subcutaneously once a day, beginning 1 to 2 hours before surgery and continued once a day postoperatively.
• High thromboembolic risk:
may be administered as a subcutaneous injection the evening before surgery and once a day postoperatively at a dose of 5000 IU per injection or as two injections of 2500 IU, each given 1 to 2 hours apart before surgery, followed by a daily injection of 5000 IU postoperatively
Therapy duration:5-10days
Prophylaxis
7500 units subcutaneous every 12 hours, OR
5000 units subcutaneous every 8-12hours
Treatment
Intravenous bolus of 80 units/kg, following continuous infusion of about 18 units/kg in hour, OR
subcutaneous injection 250 units/kg, following 250 units/kg for every 12 hours
5000 units Intravenous bolus, following continuous infusion of 1300 units/hr, OR
Dosing considerations
There are a number of concentrations available; caution is necessary to prevent the medication errors
Indicated for Deep Vein Thrombosis – Prophylaxis
150 mg orally two times a day
Note: If required, anticoagulant activity can be evaluated using aPTT or ECT instead of INR, although typically the measurement of anticoagulant activity is unnecessary with this medication
Prevention of Thromboembolism in Atrial Fibrillation
150 mg orally two times a day
Note: If required, anticoagulant activity can be evaluated using aPTT or ECT instead of INR, although typically the measurement of anticoagulant activity is unnecessary with this medication
Deep Vein Thrombosis or Pulmonary Embolism as Prophylaxis Following Hip Replacement Surgery
The recommended dosing regimen for this medication is to administer 110 mg orally 1-4 hours following surgery and after hemostasis has been achieved. Subsequently, the patient should take 220 mg orally one time a day for a duration of 28-35 days
Note: In the event that this medication is not administered on the day of surgery, treatment should begin with 220 mg orally one time a day after hemostasis has been established
Indicated for prophylactic treatment of deep vein thrombosis in patients who will undergo elective hip replacement surgery
Initially, 15 mg subcutaneously 5-15 minutes before surgery (only after regional anesthesia)
Maintain the dose at 15 mg subcutaneously every 12 hours
Carry out the evaluation risk of the bleeding disorder before drug administration
The product is discontinued in the United States
For Patients with standard bleeding risk:
Administer dose of 171 anti-Xa units/kg subcutaneously one time a day
Fixed dosing:
40 to 49 kg: dose of 7600 anti-Xa units subcutaneously one time daily
≥90 kg: dose of 17100 anti-Xa units subcutaneously one time daily
For Patients with increased risk for bleeding:
Administer dose of 86 anti-Xa units/kg subcutaneously each 12 hours
Fixed dosing:
40 to 49 kg: dose of 3800 anti-Xa units subcutaneously each 12 hours
≥90 kg: dose of 8550 anti-Xa units subcutaneously each 12 hours
Take initial dose of 300 mg, 200 mg and 100 mg orally on first, second and third day respectively
Indicated for Deep Vein Thrombosis
One time a day subcutaneously
The maximum dose is 3000 IU
Indicated for Deep vein thrombosis after abdominal surgery:
• Moderate thromboembolic risk:
2500 international units subcutaneously once a day, beginning 1 to 2 hours before surgery
• High thromboembolic risk:
may be administered as a subcutaneous injection the evening before surgery and once a day postoperatively at a dose of 5000 IU per injection
Indicated for Deep vein thrombosis after Hip replacement surgery:
• Day of surgery-preoperative start
Subcutaneous administration of 2500 international units within two hours of surgery
• Postoperative period
2500 international units subcutaneously 4 to 8 hours after surgery thereafter 5000IU every day
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