Sandbox vidit3

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Agent	Dosage
Direct FXa inhibitors
Argatroban	Bolus: None Continuous infusion: ♦ Normal organ function - 2 μg/kg per minute ♦ Liver dysfunction (total serum bilirubin 1.5 mg/dL), heart failure, postcardiac surgery, anasarca - 0.5-1.2 μg/kg per minute
Lepirudin	Bolus:0.2 mg/kg (only for life- or limb-threatening thrombosis) Continuous infusion: ♦ Cr < 1.0 mg/dL - 0.10 mg/kg per hour ♦ Cr 1.0-1.6 mg/dL - 0.05 mg/kg per hour ♦ Cr 1.6-4.5 mg/dL - 0.01 mg/kg per hour ♦ Cr > 4.5 mg/dL - 0.005 mg/kg per hour
Bivalirudin	Bolus: None Continuous infusion: ♦ Normal organ function - 0.15 mg/kg per hour ♦ Renal or hepatic dysfunction - dose reduction may be appropriate
Indirect FXa inhibitors
Danaparoid	Bolus: ♦ < 60 kg - 1500 U ♦ 60-75 kg - 2250 U ♦ 75-90 kg - 3000 U ♦ > 90 kg - 3750 U Accelerated initial infusion: 400 U/hour X 4 hours, then 300 U/hour X 4 hours Maintenance infusion: ♦ Normal renal function - 200 U/hour ♦ Renal insufficiency - 150 U/hour