Heparin Nomogram

[Emily24]

Hi,

I am a student at a medical ward and we don't get a lot patients with complicated cardiac issues. I was going through the heparin Monograms and I noticed that there is a monogram for acute coronary syndrome which has lower dosage of heparin and another monogram for full dose. Why is it that some patients are placed on different monograms? and why is it that some patients with MI recieve heparin whereas some others don't?

I already went through my pharm,medsurg book but couldn't find an answer

Thanks

[PacoUSA, BSN, RN]

At our hospital, the nomogram for DVT/PE entails a more aggressive heparin tx than one for other cardio issues, mainly because anticoagulation is more critical in patients with DVT/PE. That is my simple answer.

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[ICULINDA]

Hi I am a student at a medical ward and we don't get a lot patients with complicated cardiac issues. I was going through the heparin Monograms and I noticed that there is a monogram for acute coronary syndrome which has lower dosage of heparin and another monogram for full dose. Why is it that some patients are placed on different monograms? and why is it that some patients with MI recieve heparin whereas some others don't? I already went through my pharm,medsurg book but couldn't find an answer Thanks[/quote']

When you hang a heparin drip you are starting at a dosage based on the patients ptt and the medical reason for being on the drip to begin with. Each patient will vary. I've seen some patients not receive heparin if they have a history of HIT or a bleed in the brain. Again it varies from patient to patient.