Hematology and Oncology
Venous thromboembolism PROPHYLAXIS options
As a critical care pharmacist, it is crucial to identify patients who require venous thromboembolism (VTE) prophylaxis and those who should avoid it. According to the CHEST Guidelines, prophylaxis is recommended for acutely ill hospitalized medical patients at increased risk of thrombosis (hip replacement, obesity, cancer, advanced age, etc) , unless contraindicate…
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Thromboembolism
Use enoxaparin for thromboembolism in pregnant women
As a professional pharmacist, you will hear more about PREVENTING venous thromboembolism (VTE) during pregnancy due to new expert guidance from American College of Obstetricians and Gynecologists (ACOG) and others. VTE accounts for about 10% of maternal deaths in the United States. Watch for women who are at risk during pregnancy and postpartum, such as those with …
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Thromboembolism
Thrombotic thrombocytopenia after Janssen or AstraZeneca vaccines
Patients will ask whether COVID-19 vaccines increase clot risk. This is due to reports of serious blood clots along with low platelets after the Johnson & Johnson/Janssen vaccine in the U.S and the AstraZeneca vaccine in other countries. Both are viral vector vaccines. Now the Janssen vaccine emergency use authorization (EUA) fact sheets will warn about this …
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Obesity
How to dose low-molecular-weight heparin (Clexane, etc) in very obese patients
There's still controversy about how to dose low-molecular-weight heparin (Clexane, etc) in very obese patients. Some physicians worry that doses based on total body weight will be too high for patients over 150 kg. This leads them to cap the dose to try to prevent overdosing. In fact, dalteparin labeling recommends a maximum treatment dose, the other low-molecula…
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Thromboembolism
Weigh venous thromboembolism (VTE) prevention strategies in COVID-19
Clinicians are scrambling to optimize venous thromboembolism (VTE) prophylaxis for hospitalized patients with COVID-19. Data suggest these patients have a higher VTE risk than other hospitalized patients. Plus D-dimer and other markers are often elevated in COVID-19 especially in severe cases. But there’s little evidence about optimal VTE prophylaxis in patients wi…
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Thromboembolism
Simple guide for venous thromboembolism (VTE) prophylaxis after surgery or hospitalization
When is venous thromboembolism (VTE) prophylaxis needed after hospitalization? Not very often . Stay alert for appropriate use. Hip or knee replacement patients Continue to recommend VTE prophylaxis for 14 to 35 days after knee or hip replacement. Recommend using a direct oral anticoagulant (DOAC), such as Eliquis (apixaban) or Xar…
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Hematology and Oncology
Note on treating venous thromboembolism (VTE)
Discover key insights into managing venous thromboembolism (VTE) with our concise guide. From preferred anticoagulants to treatment duration and recurrence management, we unravel critical considerations for optimal patient care. Which anticoagulant is preferred? How long should anticoagulation be used? When might a low-dose DOAC be considered long-term? …
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