Table 2.
Anticoagulant drugs in pediatric patients.
| Mechanism of action | Half life | Excretion | Therapeutic dose | Monitoring | Antidote | |
|---|---|---|---|---|---|---|
| Unfractionated heparin | Indirect thrombin inhibitor | 1–2 h | Endothelialreticulum system | Loading 75 U/kg bolus IV Maintenance <1 year: 28 U/kg/h >1 year: 20 U/kg/h |
APTT (60–85 s) Anti Xa activity (0.35–0.7 U/ml) |
Protamine sulfate |
| Low molecular weight heparin (enoxaparin) | Xa Factor inhibitor | 3–6 h | Renal |
Preterm neonates 2 mg/kg/dose every 12 h Term neonates 1.7 mg/kg/dose every 12 h SC <2 months: 1.5 mg/kg/dose every 12 h SC >2months: 1 mg/kg/dose every 12 h SC |
Anti-Xa activity (0.5–1.0 U/ml) | Protamine Sulfate (partial reversal) |
| Vitamin K antagonist | Vitamin K inhibitor | 36 hr | Hepatic | Loading 0.6 mg/kg – single dose daily | PT/INR (2–3) | No antidote Vitamin K Prothrombin Complex concentrate to restore coagulation factors |