In patients with elevated aPTTs as a result of heparin after protamine administration, a second dose of protamine may be considered.6, One milligram (mg) of protamine sulfate will neutralize approximately 100 anti-Xa units of a LMWH.3,5,6 Similar to UFH, protamine dosing for LMWH reversal is dependent on the timing of LMWH administration relative to need for reversal. Review our Privacy Policy and Terms of Use to learn how Abiomed protects your data. Regardless of the heparin or LMWH dosage, the maximum recommended protamine dose is 50 mg.7,8 Because protamine can exhibit a weak anticoagulant effect at higher doses within a short period of time, excessive protamine dosing to reverse heparin or LMWH can paradoxically result in an increased risk of bleeding. CHAPTER 23 Heparin Calculations Objectives After reviewing this chapter, you should be able to: 1. Infusion or 1 × dose. David McAuley, Pharm.D. You will be required to solve problems that require you to understand: unit/kg/hr, unit/hr, and mL/hr. What rate will the IV pump be set to? heparin dosing calculator - nomogram for DVT, PE, and acute coronary syndromes (ACS). Calculator.

As more time elapses from heparin administration, less protamine is necessary to reverse the anticoagulant effects. Results ... Smith has ordered a heparin infusion of 1,000 units/hour (u/hr) for John Doe in bed 7. Dose ordered. These practice problems for heparin drip calculations will test your ability to calculate: new flow rate (mL/hr) based on a PTT, determining the amount of units needed for a bolus, units/hr to infuse based on the physician’s order, and how to convert units/kg/hr to determine the amount of Heparin the patient will be receiving based on their weight. Heparin Drip Calculation Reference (sample calculations for reference only!) The infusion is to be mixed as 25,000 units (u) in 500 milliliters (mL) .9% NS. For patients on heparin infusions, due to the half-life of heparin, the amount of heparin administered over the previous 2 hours should be utilized to calculate a protamine dose.3,5, The half-life of protamine, about 7 minutes, is significantly shorter than UFH.3,5,6 Consideration to measure the activated partial thromboplastin time (aPTT) after protamine administration may be warranted. Dr. Kantorovich earned his Associate of Science degree with an emphasis in chemistry from William Rainey Harper College and received his Doctor of Pharmacy degree from the University of Illinois at Chicago College of Pharmacy in 2012. the risk of You also understand and acknowledge that you should never disregard or delay seeking medical advice relating to treatment or standard of care because of information contained in or transmitted through this website. 1,2, For both enoxaparin and dalteparin, protamine does not provide a complete reversal of anti-Xa activity. About This Calculator. The Duke Heparin Protocol helps manage floor based heparin infusions at Duke University Hospital.

This site complies with the HONcode standard for trust- worthy health information: verify here. Search for CEPD317. His weight is 75kg. Accurate heparin infusion rate is important in patients with Impella Catheter. Your personal information is important to us.

State the importance of calculating heparin dosages accurately 2. Please enter your email address. Dr. Kantorovich is a Clinical Assistant Professor of Pharmacy Practice at Chicago State University College of Pharmacy and Clinical Pharmacy Specialist in the area of Internal Medicine at Advocate Christ Medical Center in Oak Lawn, Illinois.