Acute Mi Care Map Standard Pre-Printed Orders Page 4
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4ACUTE 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
No
Yes
________________________________________________________________________________________________________
Weight
kg
_______________
STEMI Post-Fibrinolytics:
Antiplatelet agent
Fibrinolytic therapy patients: 12 lead ECG at 1 and
8 hours post infusion, neurological assessment at
ASA EC
mg po once daily (usual dose 81 - 325 mg)
________
baseline, q1h x 2, then q4h x 24 hours
Clopidogrel
mg po (LOAD) x 1
________
(less than 75 years usual load 300 mg po - ensure
load not already given; greater than or equal to 75
years NO load)
Clopidogrel
mg po once daily (usual dose 75 mg)
________
Anticoagulant:
NOTE: Enoxaparin not recommended in renal
insufficiency with CrCl less than 30 mL/minute.
NOTE: Check ER record for first dose given
Enoxaparin (LESS THAN 75 years of age)
1 mg/kg subcut q12h
(maximum 100 mg per dose in first 24 hours)
Weight
Dose
40 - 49 kg = 40 mg
50 - 69 kg = 60 mg
70 - 89 kg = 80 mg
90 - 109 kg = 100 mg
110 - 129 kg = 100 mg x first 2 doses,
then 120 mg thereafter
130 - 149 kg = 100 mg x first 2 doses,
then 140 mg thereafter
Greater than 149 kg = Use unfractionated heparin
Enoxaparin (75 years of age OR OLDER)
aPTT 6 hours post start of heparin IV infusion then
0.75 mg/kg subcut q12h
once daily
(maximum 80 mg per dose in first 24 hours)
INR on day 1
Weight
Dose
40 - 49 kg = 30 mg
50 - 69 kg = 40 mg
70 - 94 kg = 60 mg
95 - 119 kg = 80 mg
120 - 149 kg = 80 mg x first 2 doses,
then 100 mg thereafter
Greater than 149 kg = Use unfractionated heparin
Refer to acute coronary syndrome heparin IV dose
adjustment form
Discharge patient when all clinical outcomes are met.
Signature and Designation
D
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Transcriber’s Signature
D
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PAGE 3 OF 3
01/16
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Parent category: Life