Drug Reference
Cardiac
Heparin (unfractionated)
Also: UFH
Indirect thrombin inhibitor (via antithrombin)
IndicationAdult
ACS / with fibrinolysisAdult60 U/kg bolus (max 4,000 U), 12 U/kg/h (max 1,000 U/h)
VTE / PEAdult80 U/kg bolus, 18 U/kg/h; titrate to aPTT/anti-Xa
Indications
- ACS
- Pulmonary embolism / DVT
- AFib before cardioversion
Contraindications & cautions
- Active major bleeding
- History of HIT
- Severe thrombocytopenia
Key pearls
- Preferred when lysis, procedures, or renal failure are likely (short half-life, reversible)
- Reverse with protamine 1 mg per 100 U given in the last 2–3 h