Table 6

Clinical use of antithrombotic therapy

Oral antiplatelet therapy
Aspirin initial dose: 160–325 mg non-enteric formulation, followed by 75–100 mg daily
 Clopidogrel 75 mg/day after a loading dose of 300 mg (600 mg when rapid onset of action is wanted)

Anticoagulants

 Fondaparinuxa 2.5 mg subcutaneously daily
 Enoxaparina 1 mg/kg subcutaneously every 12 h
 Dalteparina 120 IU/kg every 12 h
 Nadroparina 86 IU/kg every 12 h
 UFH intravenous bolus 60–70 U/kg (maximum 5000 IU) followed by infusion of 12–15 IU/kg/h (maximum 1000 U/h) titrated to aPTT 1.5–2.5 times control
 Bivalirudina intravenous bolus of 0.1 mg/kg and infusion of 0.25 mg/kg/h. Additional intravenous bolus of 0.5 mg/kg and infusion increased to 1.75 mg/kg/h before PCI

GP IIb/IIIa inhibitiona

 Abciximab 0.25 mg/kg intravenous bolus followed by infusion of 0.125 µg/kg/min (maximum 10 µg/min) for 12–24 h
 Eptifibatide 180 µg/kg intravenous bolus (second bolus after 10 min for PCI) followed by infusion of 2.0 µg/kg/min for 72–96 h
 Tirofiban 0.4 µg/kg/min intravenously for 30 min followed by infusion of 0.10 µg/kg/min for 48–96 h. A high-dose regimen (bolus 25 µg/kg + 0.15 µg/kg/min infusion for 18 h) is tested in clinical trials
Oral antiplatelet therapy
Aspirin initial dose: 160–325 mg non-enteric formulation, followed by 75–100 mg daily
 Clopidogrel 75 mg/day after a loading dose of 300 mg (600 mg when rapid onset of action is wanted)

Anticoagulants

 Fondaparinuxa 2.5 mg subcutaneously daily
 Enoxaparina 1 mg/kg subcutaneously every 12 h
 Dalteparina 120 IU/kg every 12 h
 Nadroparina 86 IU/kg every 12 h
 UFH intravenous bolus 60–70 U/kg (maximum 5000 IU) followed by infusion of 12–15 IU/kg/h (maximum 1000 U/h) titrated to aPTT 1.5–2.5 times control
 Bivalirudina intravenous bolus of 0.1 mg/kg and infusion of 0.25 mg/kg/h. Additional intravenous bolus of 0.5 mg/kg and infusion increased to 1.75 mg/kg/h before PCI

GP IIb/IIIa inhibitiona

 Abciximab 0.25 mg/kg intravenous bolus followed by infusion of 0.125 µg/kg/min (maximum 10 µg/min) for 12–24 h
 Eptifibatide 180 µg/kg intravenous bolus (second bolus after 10 min for PCI) followed by infusion of 2.0 µg/kg/min for 72–96 h
 Tirofiban 0.4 µg/kg/min intravenously for 30 min followed by infusion of 0.10 µg/kg/min for 48–96 h. A high-dose regimen (bolus 25 µg/kg + 0.15 µg/kg/min infusion for 18 h) is tested in clinical trials

aSee Chronic kidney disease for specific rules of prescription in the case of renal failure.

Table 6

Clinical use of antithrombotic therapy

Oral antiplatelet therapy
Aspirin initial dose: 160–325 mg non-enteric formulation, followed by 75–100 mg daily
 Clopidogrel 75 mg/day after a loading dose of 300 mg (600 mg when rapid onset of action is wanted)

Anticoagulants

 Fondaparinuxa 2.5 mg subcutaneously daily
 Enoxaparina 1 mg/kg subcutaneously every 12 h
 Dalteparina 120 IU/kg every 12 h
 Nadroparina 86 IU/kg every 12 h
 UFH intravenous bolus 60–70 U/kg (maximum 5000 IU) followed by infusion of 12–15 IU/kg/h (maximum 1000 U/h) titrated to aPTT 1.5–2.5 times control
 Bivalirudina intravenous bolus of 0.1 mg/kg and infusion of 0.25 mg/kg/h. Additional intravenous bolus of 0.5 mg/kg and infusion increased to 1.75 mg/kg/h before PCI

GP IIb/IIIa inhibitiona

 Abciximab 0.25 mg/kg intravenous bolus followed by infusion of 0.125 µg/kg/min (maximum 10 µg/min) for 12–24 h
 Eptifibatide 180 µg/kg intravenous bolus (second bolus after 10 min for PCI) followed by infusion of 2.0 µg/kg/min for 72–96 h
 Tirofiban 0.4 µg/kg/min intravenously for 30 min followed by infusion of 0.10 µg/kg/min for 48–96 h. A high-dose regimen (bolus 25 µg/kg + 0.15 µg/kg/min infusion for 18 h) is tested in clinical trials
Oral antiplatelet therapy
Aspirin initial dose: 160–325 mg non-enteric formulation, followed by 75–100 mg daily
 Clopidogrel 75 mg/day after a loading dose of 300 mg (600 mg when rapid onset of action is wanted)

Anticoagulants

 Fondaparinuxa 2.5 mg subcutaneously daily
 Enoxaparina 1 mg/kg subcutaneously every 12 h
 Dalteparina 120 IU/kg every 12 h
 Nadroparina 86 IU/kg every 12 h
 UFH intravenous bolus 60–70 U/kg (maximum 5000 IU) followed by infusion of 12–15 IU/kg/h (maximum 1000 U/h) titrated to aPTT 1.5–2.5 times control
 Bivalirudina intravenous bolus of 0.1 mg/kg and infusion of 0.25 mg/kg/h. Additional intravenous bolus of 0.5 mg/kg and infusion increased to 1.75 mg/kg/h before PCI

GP IIb/IIIa inhibitiona

 Abciximab 0.25 mg/kg intravenous bolus followed by infusion of 0.125 µg/kg/min (maximum 10 µg/min) for 12–24 h
 Eptifibatide 180 µg/kg intravenous bolus (second bolus after 10 min for PCI) followed by infusion of 2.0 µg/kg/min for 72–96 h
 Tirofiban 0.4 µg/kg/min intravenously for 30 min followed by infusion of 0.10 µg/kg/min for 48–96 h. A high-dose regimen (bolus 25 µg/kg + 0.15 µg/kg/min infusion for 18 h) is tested in clinical trials

aSee Chronic kidney disease for specific rules of prescription in the case of renal failure.

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