10 Aug 2010
In most cases, anticoagulant therapy is the mainstay of treatment. Acutely, supportive treatments, such as oxygen or analgesia, are often required.
In most cases, anticoagulant therapy is the mainstay of treatment. Heparin, low molecular weight heparins (such as enoxaparin and dalteparin), or fondaparinux is administered initially, while warfarin, acenocoumarol, or phenprocoumon therapy is commenced (this may take several days, usually while the patient is in the hospital). Low molecular weight heparin may reduce bleeding among patients with pulmonary embolism as compared to heparin according to a systematic review of randomized controlled trials by the Cochrane Collaboration. The relative risk reduction was 40.0%. For patients at similar risk to those in this study (2.0% had bleeding when not treated with low molecular weight heparin), this leads to an absolute risk reduction of 0.8%. 125.0 patients must be treated for one to benefit (number needed to treat = 125.0.
Warfarin therapy often requires frequent dose adjustment and monitoring of the INR. In PE, INRs between 2.0 and 3.0 are generally considered ideal. If another episode of PE occurs under warfarin treatment, the INR window may be increased to e.g. 2.5-3.5 (unless there are contraindications) or anticoagulation may be changed to a different anticoagulant e.g. low molecular weight heparin. In patients with an underlying malignancy, therapy with a course of low molecular weight heparin may be favored over warfarin based on the results of the CLOT trial. Similarly, pregnant women are often maintained on low molecular weight heparin to avoid the known teratogenic effects of warfarin, especially in the early stages of pregnancy. People are usually admitted to hospital in the early stages of treatment, and tend to remain under inpatient care until INR has reached therapeutic levels. Increasingly, low-risk cases are managed on an outpatient basis in a fashion already common in the treatment of DVT.
Warfarin therapy is usually continued for 3–6 months, or "lifelong" if there have been previous DVTs or PEs, or none of the usual risk factors is present. An abnormal D-dimer level at the end of treatment might signal the need for continued treatment among patients with a first unprovoked pulmonary embolus.
I hope this informmation helps you , as my friend Rajive mentions , it would be very helpful if you tolds us what nmedications you are on.
Search for questions
Still looking for answers? Try searching for what you seek or ask your own question.
Everyone says it takes 10 to 15 to 30 minutes to dissolve their medication. I guess I have a lot of spit and it makes mine dissolve faster.. but is ...
2 answers • 3 Mar 2010
I took Sronyx for 2 months. At the end of the 2 months, I had shortness of breath. The major awakening came about when I began to hyperventilate and ...
1 answer • 7 Sep 2013
Pulmonary Embolism -- First Event - how long do I stay on coumadin after one incidence of pulmonary?
... embolism. My FMP said I should get off Warfarin after 4 years since one incidence of unexplained pulmonary embolism. What is the indicated term ...
3 answers • 29 Nov 2013
It says on the instructions dissolve one sachet in 62.5ml of water but also says for the chocolate flavoured sachets to dissolve 12 sachets in 750ml ...
1 answer • 25 Feb 2015
I was admitted on wed started on levonox discharged on thursday on xarelto.15mg bid then on day 21 started 20mg daily until.should I have been given ...
0 answers • 20 Nov 2015