The fourth edition of this handbook is designed to give the practitioner convenient access to practical information on established and emerging antithrombotic agents. Proper use of these agents can substantially reduce mortality and morbidity in patients with thrombotic diseases.

Whenever possible, algorithms are used to aid in dosing and monitoring antithrombotic agents. Some of these algorithms have been validated in prospective studies (pages 8 and 9) whereas others (pages 30-37) are derived from widespread experience. The reader should keep in mind that these algorithms are recommendations and not rigid practice guidelines. The reader will also find flow charts to help in the diagnostic approach to important thrombotic diseases including pulmonary embolism (PE), deep venous thrombosis (DVT), atrial fibrillation (AF), and myocardial infarction (MI).

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Overview Table..........................................

Heparin

Introduction ...............................................
Indications and Precautions....................
Dosing and Therapeutic Ranges.............
Guidelines for Overlapping Heparin and Warfarin......................................................
Monitoring and Dose Adjustment.........
Weight-Based Monitoring and Dose Adjustment.................................................
Prevention of Deep Venous Thrombosis/Pulmonary Embolism..........
Bleeding in Patients Receiving Heparin.
Determining the Therapeutic Range of Heparin........................................................
Evaluation of Patients with Suspected Deep Venous Thrombosis........................
Evaluation of Patients with Suspected Pulmonary Embolism.................................

Low Molecular Weight Heparins and Danaparoid

Introduction..............................................
Indications and Dosing..........................

Warfarin

Introduction...............................................
Indications and Precautions....................
Drug Interactions with Warfarin.............
INR Considerations..................................
Initiating Warfarin Therapy....................
Monitoring and Dose Adjustments......
Managing Warfarin in Patients Undergoing Surgery.................................
Bleeding in Patients on Warfarin...........
Prevention of Deep Venous Thrombosis/Pulmonary Embolism..........
Evaluation of Patients with Atrial Fibrillation..................................................

Aspirin

Introduction..............................................
Dose Regimens........................................
Indications and Precautions..................

1-2



3-4
4-5
6

7
8

9

10
11

12

13

14-16
®



17
17-20



21
22-23
24
27-29
30
31-32

33-35
36

37

38-40



41
41
42