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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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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HIT
Heparin-induced thrombocytopenia (HIT)
DESCRIPTION ㅡ There are two types of heparin-induced thrombocytopenia (HIT)... Type 1: Isolated HIT develops early in heparin therapy and is benign. No resultant bleeding or thrombotic complications. HIT type 1 NOT mediated by the immune system (passive heparin binding to platelets resulting in a modest shortening of the platelet life span). The platelet count rarel…
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