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PULMONARY EMBOLISM-MANAGEMENT

Respiratory

PULMONARY EMBOLISM-MANAGEMENT

1. The main anticoagulants are heparins, fondaparinux, and warfarin.

2. Achieve adequate anticoagulation ASAP with a heparin or fondaparinux!

3. Subcutaneous LMWH (tinzaparin, dalteparin, or enoxaparin) should be used whenever possible to treat PE (inpatients and outpatients) because of the lower risk of major bleeding and less risk of osteoporosis.

4. LMWH has no effect on thrombin like UFH does. Rather, it solely inactivates Factor Xa (so no effect on PTT).

5. LMWH can also cause heparin-induced thrombocytopenia (although less often than UFH), so monitor the platelet count.

6. For both UFH and LMWH, protamine is the antidote for bleeding.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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