This 54 year old gentleman presented to the Wickpro Conch Medical Center with an infected left lower leg pressure ulcer with open and gangrenous muscle exposed through the posterior wound. His past medical history is significant for insulin dependent diabetes mellitus, peripheral vascular disease, coronary artery disease, congestive heart failure, history of atrial fibrillation/flutter, and right sacroiliac joint decubitus ulcer. His physical examination revealed mottled distal extremities, bilateral inspiratory wheezes, and a positive bowel sound. The patient underwent a four vessel coronary artery bypass graft on 6/17/95 and left lower extremity fasciotomy on 11/27/95 and was taken to the Operating Room on 7/25/95 for a preoperative diagnosis of a left lower extremity infected pressure sore. Intraoperatively, the patient was noted to have necrosis of both heads of the gastrocnemius muscle and copious amounts of antibiotic-containing solution was used to irrigate the wound, for which he was started on Ampicillin, Gentamicin, and Flagyl empirically until culture results returned and was taken back on 2/29/95 for a second irrigation and debridement procedure. The patient was placed on Klonopin 1 mg po tid, Tylenol 650 mg p.o. q4h p.r.n. headache, Aspirin 81 mg p.o. qd, Albuterol nebulizer 0.5 cc in 2.5 cc of normal saline q.i.d., Capoten 25 mg p.o. qh, Chloral hydrate 500 mg p.o. q.h.s. p.r.n. insomnia, Clonopin 1 mg p.o. t.i.d., Digoxin 0.375 mg p.o. qd, Colace 100 mg p.o. b.i.d., Insulin NPH 38 units subcu b.i.d., Milk of Magnesia 30 cc p.o. qd p.r.n. constipation, Multivitamins one capsule p.o. qd, Mycostatin 5 cc p.o. q.i.d., Percocet one or two tabs p.o. q3-4h p.r.n. pain, Metamucil one packet p.o. qd, Azmacort six puffs inhaled b.i.d., Axid 150 mg p.o. b.i.d., Ofloxacin 200 mg p.o. b.i.d. x 7 days, and Insulin NPH 38 units in the morning and 38 units at night. The patient was initially ruled out for a myocardial infarction following his first operative procedure and had no episodes of hypotension. He was switched over from Gentamicin to Ofloxacin to continue his antibiotic course and has been followed by the Infectious Disease service, receiving 7 more days of po Ofloxacin as an outpatient. The patient's medications upon discharge include Aspirin 81 mg po qd, Digoxin 0.325 mg po qd, Azmacort 6 puffs inhaled bid, Heparin 5000 units subcu bid, Zantac 150 mg po bid, Lasix 40 mg po qd, Capoten 25 mg q 8, Albuterol nebulizers 0.5 cc in 2.5 cc normal saline qid, NPH insulin 38 units subcu bid, Nystatin swish and swallow 5 cc po qid, Bactrim DS one tab po bid, Tylenol 650 mg po q4h prn headache, Chloral hydrate 500 mg po qhs prn insomnia, Clonopin 1 mg po tid, Colace 100 mg po bid, Milk of Magnesia 30 cc po qd prn constipation, Multivitamins one capsule po qd, Mycostatin 5 cc po qid, Percocet one or two tabs po q3-4h prn pain, Metamucil one packet po qd, Azmacort six puffs inhaled bid, Axid 150 mg po bid, and Ofloxacin 200 mg po bid x 7 days.
What is the dosage of heparin
Heparin 5000 units subcu bid, Zantac 150 mg po bid,