Anticoagulation, endocrine and GI
Heparin drip
UFH
Watch the explainer
Heparin vs Warfarin: aPTT vs INR, HIT, Bridging, Antidotes and DOAC Reversal
Dosing
| Start | VTE: 80 units/kg bolus, then 18 units/kg/h. ACS: 60 units/kg bolus (max 4,000), then 12 units/kg/h (max 1,000 units/h) |
|---|---|
| Titrate | Per nomogram by aPTT or anti-Xa, usually every 6 hours |
| Maximum | ACS starting rate up to 1,000 units/h |
| Common bags | 25,000 units in 250 mL (100 units/mL); 25,000 units in 500 mL (50 units/mL) |
| Dose units | units/kg/h, units/h |
Line and administration
- High-alert drug: independent double-check of pump and bag
Watch for
- Bleeding
- Platelets: HIT on day 5–10
Heparin: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- Bleeding, Reversal, HIT and DICReversing anticoagulants in major bleeding: Unfractionated heparin: Protamine 1 mg per 100 units given in last 2–3 h (max 50 mg): Fast; watch for hypotension, anaphylaxis
- Pulmonary EmbolismDiagnosis: unstable vs stable: Shock or hypotension: Heparin now; bedside echo or CTPA, whichever is faster
- CRRT (Continuous Renal Replacement)Anticoagulation: KDIGO suggests regional citrate over heparin when citrate is safe: longer filter life, less bleeding.
- Impella Heart PumpPurge system: Add heparin 25 or 50 units/mL, or bicarbonate 25 or 50 mEq/L if heparin is contraindicated. Never both; no other anticoagulant.
- Peripheral Vascular EmergenciesAcute limb ischemia: Notify the provider at once; expect IV heparin on diagnosis and emergency vascular review
- ECMO EssentialsMonitoring and anticoagulation: Anti-Xa on UFH: 0.3–0.7 IU/mL
Practice Bleeding, Reversal, HIT and DIC questions free34 exam-style questions with rationales on the topic where heparin comes up most. No account or download needed.
Other anticoagulation, endocrine and gi
- Insulin (regular)
- Amiodarone
- Diltiazem
- Octreotide
- Pantoprazole
- Furosemide
- Argatroban
- Bivalirudin
- Procainamide
- Lidocaine
- Magnesium sulfate
- Naloxone
- Eptifibatide
- Bumetanide
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For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against the order, the bag label, your pump library and your institution's protocol.