In UA/NSTEMI patients undergoing PCI who are at high risk of bleeding, bivalirudin anticoagulation is reasonable. UFH IV GP IIb/IIIa planned: target ACT 200 250 s IV GP IIb/IIIa planned: 50 70 units/kg bolus to achieve an ACT of 200 250 s No IV GP IIb/IIIa planned: target ACT 250 300 s for HemoTec, 300 350 s for Hemochron (Class I, LOE: B) No IV GP IIb/IIIa planned: 70 100 units/kg bolus to achieve target ACT of 250 300 s for HemoTec, 300 350 s for Hemochron (Class I, LOE: B) *This list is in alphabetical order and is not meant to indicate a particular therapy preference. This drug table does not make recommendations for combinations of listed drugs. It is only meant to indicate an approved or recommended dosage if a drug is chosen for a given situation. The optimum LD of clopidogrel has not been established. Randomized trials establishing its efficacy and providing data on bleeding risks used an LD of 300 mg orally followed by a daily oral dose of 75 mg. Higher oral LDs such as 600 mg or more than 900 mg of clopidogrel more rapidly inhibit platelet aggregation and achieve a higher absolute level of inhibition of platelet aggregation, but the additive clinical efficacy and safety of higher oral LD have not been rigorously established. For post-PCI patients receiving a DES, a daily MD should be given for at least 12 mo unless the risk of bleeding outweighs the anticipated net benefit afforded by a P2Y12 receptor inhibitor. For post-PCI patients receiving a BMS, an MD should be given for up to 12 mo (unless the risk of bleeding outweighs the anticipated net benefit afforded by a P2Y12 receptor inhibitor; then it should be given for a minimum of 2 wk). 