Acute Mi Care Map Standard Pre-Printed Orders (Page 3 of 4) in pdf

ACUTE MI CARE MAP

STANDARD PRE-PRINTED ORDERS:

Anticoagulant/Antiplatelet

Approved Initiative of the Winnipeg Regional Health Authority

These orders are to be used as a guideline and do not replace sound clinical judgement and professional practice standards.

Patient allergy, contraindications and clinical condition must be considered when completing these orders.

[

Standard orders. If not in agreement with an order cross out and initial.

Requires a check (

) for activation

ORDER

MEDICATION ORDERS

GENERAL ORDERS

TRANSCRIBED

Allergies:

Unknown

Yes

________________________________________________________________________________________________________

Weight

_______________

Non-STEMI & STEMI with NO

Fibrinolytics:

Antiplatelet Agent

ASA EC

mg po once daily

________

(usual dose 81 - 325 mg)

Note: if on ticagrelor maximum ASA dose is 100 mg

Additional Antiplatelet Agent

Clopidogrel

mg po x 1 (LOAD)

________

(usual dose 300 - 600 mg po - ensure load not

already given)

Clopidogrel

mg po once daily (usual dose 75 mg)

________

Ticagrelor

mg po x 1 (LOAD)

________

(usual dose 180 mg po - ensure load not already

given)

Ticagrelor

mg po q12h (usual dose 90 mg)

________

Anticoagulant Agent

(Enoxaparin and fondaparinux not recommended in

renal failure with Crcl less than 30 mL/minute. See AMI

standards document for options)

Enoxaparin 1 mg/kg subcut q12h

(maximun single dose 140 mg)

40 - 49 kg = 40 mg

50 - 69 kg = 60 mg

70 - 89 kg = 80 mg

90 - 109 kg = 100 mg

110 - 129 kg = 120 mg

130 - 149 kg = 140 mg

(2 syringes: 100 mg + 40 mg)

Greater than 149 kg

Use unfractionated heparin

Fondaparinux 2.5 mg subcut q24h

(Medical management only; not for use if planned/

likely PCI or CABG)

Refer to acute coronary syndrome heparin IV dose

adjustment form

Discharge patient when all clinical outcomes are met.

Signature and Designation

Transcriber’s Signature

PAGE 2 OF 3

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Acute Mi Care Map Standard Pre-Printed Orders Page 3

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