Pulmonary thromboembolism

Plasminogen, an inactive precursor, is activated to plasmin which as a protease is able to break down fibrin clots. The thrombolytic agents in use promote the conversion of plasminogen to plasmin at the site of a thrombus. Indications include post-myocardial infarction treatment. The thrombolytic must be administered within 6 hours for an optimal effect. Other indications are treatment of acute pulmonary thromboembolism, deep-vein thrombosis, acute arterial thrombosis and thromboembolism, as well as in the clearance of arteriovenous catheters and can-nulae. Agents are streptokinase, anistreplase, urokinase, alteplase, reteplase and tenecteplase. 

I Unlabeled Uses Prevention of deep venous thrombosis, prevention and treatment of orthostatic hypotension, pulmonary thromboembolism... 

Zreik TG, Odunsi K, Cass I, Olive DL, Sarrel P. A case of fatal pulmonary thromboembolism associated with the use of intravenous estrogen therapy. Fertil Steril 1999 71(2) 373-5. 

Sartwell PE, et al. Oral contraceptives and relative risk of death from venous and pulmonary thromboembolism in the United States an epidemiologic case-control study. Am J Epidemiol 1969 90 365. 

Acute massive pulmonary thromboembolism has been attributed to olanzapine in two patients (60) ... 

Kamijo Y, Soma K, Nagai T, Kurihara K, Ohwada T. Acute massive pulmonary thromboembolism associated with risperidone and conventional phenothiazines. Circ J 2003 67 46-8. 

Woo KS, Tse LK, Woo JL, Vallance-Owen J. Massive pulmonary thromboembolism after antifibrinolytic therapy. Ann Emerg Med 1989 18(1) 116-17. 

A 33-year-old woman with Evans syndrome received intravenous immunoglobulin 400 mg/kg/day and developed a deep vein thrombosis after 1 week (47). She was treated with warfarin, and 6 months later received an additional course of intravenous immunoglobulin for recurrent hemolytic anemia 1 day later she died of pulmonary thromboembolism. 

Massive pulmonary thromboembolism was reported in a 62-year-old woman 7 days after treatment with high doses for subarachnoid hemorrhage (43). 

The antiplatelet activity of nitroaspirins NCX-4215 and NCX-4016 was compared in vitro to aspirin with comparable results for maximal inhibition of arachi-donic acid-stimulated platelet aggregation (50). Furthermore, NCX-4016 was more efficient in inhibiting platelet activation induced by thrombin (48, 50). This was reversed by oxyhemoglobin and methylene blue acid, further supporting the NO-related inhibitory effect. NCX-4016 was shown to possess greater antiinflammatory and analgesic activity (51, 52). The antithrombotic activity of NCX-4016 was also present in vivo (53) and reduced pulmonary thromboembolism... 

Prevention of pulmonary thromboembolism by NCX4016, a nitric oxide-releasing aspirin. Eur. J. Pharmacol. 397 177-85... 

Park JH, Park YS, Park SJ, et al. Midventricular peak systolic strain and Tei index of the right ventricle correlated with decreased right ventricular systolic function in patients with acute pulmonary thromboembolism. International Journal of Cardiology 2008 125(3) 319-24. 

To evaluate the role of specific aniline derivatives in the induction of an autoimmune response, animals were exposed to purified anilides and PAP esters. Oleyl and linoleyl anilides were found to be toxic to the rat lung (Tena, 1982), and anilides induced elevated IgE levels and T cells in mice (Lahoz et al., 1997). Neither PAP nor its monoester induced overt toxicity in Lewis and LAC rats or MF1 mice, but PAP induced mesenteric and pulmonary thromboembolism in rats (Gelpi et al., 2002). Most anilides possess... 

In a mouse model of pulmonary thromboembolism induced by intravenous injection of a collagen-epinephrine mixture, administration of 100 mg/kg of lavandin essential oil daily significantly reduced thrombotic events without inducing prohemorrhagic complications at variance with acetylsali-cylic acid used as a reference drug (Ballabeni et al. 2004). 

In a phase II trial of bevacizumab with dacarbazine and daily low-dose interferon alfa-2a as first-line treatment in 26 patients with metastatic melanoma, there were four life-threatening adverse events pulmonary thromboembolism (n = 2), intracerebral hemorrhage (n = l), and grade 4 hypertension ( = 1). In two cases the event occurred at least 3 months after the last dose [86 ]. 

Cardiovascular Clozapine, which is close related to olanzapine, has been implicated as an independent susceptibility factor for pulmonary embolism [SEDA-28, 65]. A possible association between olanzapine and pulmonary thromboembolism has also been described [SEDA-32,102]. New cases have been reported [97", 98" ]. 

Borras L, Eytan A, de Timary P, Constant EL, Huguelet P, Hermans C. Pulmonary thromboembolism associated with olanzapine and risperidone. J Emerg Med 2008 35(2) 159-61. 

MunoK RN, Praharaj SK, Bhat SM. Clozapine-induced recurrent pulmonary thromboembolism. J Neuropsychiatry Clin Neuroscis... 

Chate S, Patted S, Nayak R, Patil N, Pandurangi A. Pulmonary thromboembolism associated with clozapine. J Nevuopsychiatry Clin Neu-... 

Observational studies In a multicenter, observational retrospective review of 127 patients (80 male, mean age 51.7years) who had undergone at least ISmonths of treatment with alpha-l-antitrypsin therapy (Trypsone or Pro-lastin ), there were four serious adverse events that occurred during the treatment period one massive pulmonary thromboembolism, one myeloid leukaemia, one acute myocardial infarction and one haemorrhagic infarcHon but were judged not to be related to treatment. Seven of 11 nonserious adverse events were considered related to treatment including mild to moderate cutaneous symptoms (facial erythema, oedema/pruritus, rash), chills, fever and anxiety [31 ]. 

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