argatroban dosing calculator
Argatroban should be continued as bridging therapy with oral anticoagulation of the coumarin type for a. In the 12-week controlled phase the rate of all infections in the ACTEMRA-IV group was 345 per 100 patient-years and 287 per 100 patient-years in the placebo group.
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Obtain additional ACTs every 20 to 30 minutes during a prolonged procedure.
. For pts w or at risk for HITHITT. Doses between 015 to 13 mcgkgminute were required to maintain aPTTs in the target range Reichert 2003. Argatroban dosing in obesity Thromb Res.
Based on these results argatroban should be dosed using actual body weight regardless of BMI. Dose to 15 mcgkgmin IV. There are no specific guidelines for dosing in hepatic impairment and therefore argatroban should be avoided in patients with any degree of hepatic impairment.
Bleeding rates were lower but not significantly in patients receiving argatroban 10 for heparin vs. Marchetti and colleagues critically and systematically reviewed their institutional experience using this direct thrombin inhibitor to treat patients with laboratory-confirmed HIT and have formulated several practical recommendations for. Get the Vancomycin Dosing Calculator - A HughesMedicine App.
Measure aPTT after 2 hours. For medications that are renal adjusted argatroban Angiomax bivalirudin Integrilin milrinone you may use the creatinine. 26 for low-dose argatroban and 43 for high-dose argatroban26106.
25 mcgkgmin IV infusion AND. O Initiate dose at 05 mcgkgmin o Half-life can be extended up to 180 minutes 3 x normal half-life of 39-51 minutes In patients with renal impairment o Argatroban is not renally eliminated and does not require initial dosage adjustments Clinical conditions which may warrant dosing as low as 01 or 02 mcgkgmin. Dose to 30 mcgkgmin IV.
Co-administered with Argatroban at a dose of 2 mcgkgmin. Adult Infusion Rate Calculator The Adult Infusion Rate. The PCI procedure may proceed if the ACT is greater than 300 seconds.
Discontinue all parenteral anticoagulants and obtain a baseline aPTT before initiation of therapy. PTT Rate Adjustment Recheck PTT from time of dose change Normal Hepatic Function. The IV Drip Rate Calculator calculator is created by QxMD.
If you hold down the shift key you can select an entire range of drugs for example you can click on the first drug in the list and then while holding the shift key select the last drug and you will notice that the. A bolus of 350 mcgkg IV over 3-5 minutes via large-bore IV line. See the Argatroban Adjustment Dosing Calculator.
To calculate INR for warfarin alone INR W based on INR for co-therapy of warfarin and Argatroban INR WA when the Argatroban dose is 2 mcgkgmin use the equation next to the appropriate curve. Determine aPTT 2 hours after initiation of infusion andor dosage adjustment to confirm achievement of a target aPTT of 153 times the initial baseline aPTT not to exceed 100. The purpose of the infusion rate calculator is to prevent medication errors help standardized concentrations and assist the nurse taking care of the patient.
When initiated argatroban should be dosed the same in those with HITT and isolated HIT. 075 mcgkgminute by continuous IV infusion. In the open-label extension over an average duration of 73 weeks of treatment the overall rate of.
Obtain ACTs before dosing 5 to 10 minutes after bolus dosing following adjustments in the infusion rate and at the end of the PCI procedure. If ACT 450sec after initial bolus decr. However these differences were not statistically different.
Calculations and document all dose changes on the Argatroban Flow Sheet. Standard Argatroban Infusion is 250mg in Normal Saline 250mL yielding a concentration of 1 mgmL or 1000 mcgmL. Check an activated clotting time ACT 5 to 10 minutes after the bolus dose is completed.
Drug Dosage Calculations Female Humans. Please seek haematology advice if necessary. For example the authors advise a starting dose of 10 μgkgmin normal liver function but lower doses 075 050 and 025 μgkgmin respectively for patients with.
Stopping this drug too early could result in a lapse in therapeutic anticoagulation. It is a useful tool to determine the rate of pump medication infusion to achieve therapeutic dosing. If argatroban therapy is used concurrently with or following FFP or a thrombolytic some centers decrease dose by half.
Obtain an activated clotting time ACT 5 to 10 minutes after the bolus dose is completed. This program allows for multiple selections. Argatroban interferes with the INR assay.
Maximum dose 10mcgkgmin Switching to warfarin. Argatroban injection prescribing information Sandoz 0516. Argatroban Dosage and Administration General Laboratory Monitoring.
It is used as an alternative anticoagulant in patients with heparin-induced thrombocytopenia HIT. Argatroban is a a small molecule synthetic direct thrombin inhibitor. Dosing and monitoring of argatroban for treatment of heparin-induced thrombocytopenia HIT remain uncertain.
This is a general formula to administer medications in a weight-based infusion rate. If ACT dose IV x1 then incr. Indicated as an anticoagulant in patients with or at risk for heparin-induced thrombocytopenia undergoing percutaneous coronary intervention PCI Initial.
To pick and choose one drug at a time hold down the ctrl key and make as many selections as you need. Critically-ill patients with normal hepatic function have become excessively anticoagulated with FDA-approved or lower starting doses of argatroban. 350 mcgkgdose IV x1 then 25 mcgkgmin IV.
Modifiers to this equation are dependent on units selected for each component. Adjust dose until the steady-state aPTT is 15 to 3 times the initial baseline value. Check activated clotting time ACT 5-10 minutes after bolus dose is completed.
Therapeutic Goal Range for PTT is 55-100. The dose for heparin-induced thrombocytopenia without hepatic impairment is 2 mcgkgmin administered as a continuous infusion 21 Discontinue heparin therapy and obtain a baseline aPTT before administering Argatroban 21 After the initial dose of Argatroban the dose can be adjusted as clinically indicated 21. This table includes numerous dosing and monitoring pearls and is the basis for the title of my commentary How to dose and monitor argatroban for treatment of HIT.
Get the app to quickly determine an ideal vancomycin regimen estimate a steady-state trough concentration and adjust an existing regimen. Dosing and titrating argatroban. TIMI grade 3 blood flow at 90 minutes trended towards improvement with argatroban.
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