Enoxaparin 1mg/kg q12h x 4-5 days
Warfarin
Starting dose of 5mg/day
Give 7d supply with first dose in ED
Starting dose of 5mg/day
Give 7d supply with first dose in ED
15mg PO BID x 21 days
Then 20mg PO daily (duration depending on risk factors)
Then 20mg PO daily (duration depending on risk factors)
10mg PO BID x 7 days
Then 5mg PO BID daily (duration depending on risk factors)
Then 5mg PO BID daily (duration depending on risk factors)
Enoxaparin 1mg/kg q12h x 4-5 days
Pradaxa 150mg BID 
Unfractionated Heparin 80 units/kg bolus
Then 18 units/kg/hour
Check PTT after 6hr; adjust infusion to maintain PTT at 1.5-2.5x control
Warfarin as above
Then 18 units/kg/hour
Check PTT after 6hr; adjust infusion to maintain PTT at 1.5-2.5x control
Check creatinine on all patients prior to initiation
CrCl <30 avoid use
No dosage adjustments necessary for renal impairment
However, CrCl <25 mL/minute were excluded from clinical trials
However, CrCl <25 mL/minute were excluded from clinical trials
CrCl<50 avoid use
Active hemorrhage
Platelets <50
History of intracerebral hemorrhage
Deep venous thrombosis
Arterial thrombosis
Venous thromboembolism
Arteritis
Lymphangitis
Arthritis
Phlebitis
Buerger disease