Thrombophlebitis prevention

This drug is used for preventing and treating thrombosis, thrombophlebitis, thromboe-molium, and for preventing thrombo-formation in post-operational periods. Synonyms of this drug are bishydroxycoumarin, dicumol, cromolyn, and others. 

Like coumarin derivatives, phenindione, a compound of the indandione class, acts by altering biosynthesis of coagulant proteins in the liver. It is used for preventing and treating thrombosis, thrombophlebitis, and thromboembolism. However, because of a number of side effects such as poly urea, polydipsia, tachycardia, and others, it is rarely used in practical medicine. Synonyms of this drug are pindone, bindan, gevuUn, indan, phenyhne, and rectadione. 

Aside from its use as an antimalarial compound, quinine is used for the prevention and treatment of nocturnal leg muscle cramps, especially those resulting from arthritis, diabetes, thrombophlebitis, arteriosclerosis, and varicose veins. 

A low dosage of progestin ( mini-pill ) is used, in the form of medroxyprogesterone acetate, which is active at a very low dose. The mini-pill does not inhibit ovulation, but rather interferes with the endometrium and the cervical mucus. The use of this pill prevents most of the side effects of oral contraception, specifically nausea, water retention, and in some cases thrombophlebitis. However, a lower success rate and other frequent side effects have reduced the widespread acceptance of this preparation. Nevertheless, the mini-pill has a role to play in certain specific situations. For example, in an uncommon form of epilepsy called catamenial epilepsy, female patients will experience seizures at particular times during their menstrual cycle, reflecting the fact that seizure focus is stimulated by estrogens but inhibited by progestins. In such women, the mini-pill may afford not only birth control but also improved seizure control. 

Raloxifene Interacts selectively with estrogen receptors Inhibits bone resorption without stimulating breast or uterus Osteoporosis Does not prevent hot flashes increased risk of thrombophlebitis... 

Thrombophlebitis at the infusion site is a common complication of continuous infusion of various clotting factor concentrates and has been noted after infusion of factor Vila (9,10). Thrombophlebitis occurred in one of eight hemophiliacs with inhibitors who received continuous infusion of recombinant factor Vila to allow elective surgery (11). In 25 hemophilia patients with inhibitors, who received recombinant factor Vila for surgical procedures or spontaneous bleeding, there was one case of thrombophlebitis in 35 continuous infusion courses (12). In most instances, thrombophlebitis can be prevented by parallel infusion of saline or heparin. 

Small doses of heparin are used for the prophylaxis of infusion-related thrombophlebitis (23). Low molecular weight heparin is added to recombinant factor Vila to prevent a 50% loss of activity of factor VII within 4 hours of storage (9). In one case, however, there was co-preci-pitation of reconstituted factor Vila and low molecular weight heparin in syringes (24). The authors therefore suggested that a parallel saline infusion be used instead of heparin to prevent thrombophlebitis. 

Vancomycin (Vancocin) Prevents transfer of cell wall precurser from plasma membrane to cell wall. DOC Antibiotic associated colitis (C. d/ff/c//e). Staph and Strep infections which are resistant to penicillin or methacillin. Thrombophlebitis, ototoxicity, nephrotoxicity. When administered by rapid IV tachycardia, flushing, paresthesias, hypotension, severe nephrotoxicity... 

Rotation or prompt removal of catheters during periods of sepsis is indicated for prevention of septic thrombophlebitis. 

Propylene glycol and 20 % Cremophor EL have been compared as vehicles for diazepam [170] in view of the number of reports of thrombophlebitis associated with intravenous diazepam. The Cremophor vehicle caused significantly less postinjection thrombophlebitis possibly because it prevents the precipitation of the drug substance at the site of injection by its solubilizing effect. Ease of injection... 

The problem is to prevent instability, not only to maintain the appearance of the emulsion, but so that the characteristics of the emulsion and of medicaments dissolved in the emulsion are as little changed on ageing as possible. As an example, ageing might alter the absorption of heparin from O/W emulsions where absorption of heparin appears to be directly related to the particle size and total surface area of the oil droplets [11]. Fat emulsions are used extensively in intravenous feeding [12] where it is vital that particles remain below 1 in diameter to avoid thrombophlebitis and other complications, but the state of the art is exemplified by the statement [13], that the emulsions must be stored in a refrigerator and no antibiotics, vitamins or potassium supplements added because they may break the emulsions . Lynn [14] reports some experiments on the addition of disodium carbenicillin and sodium cloxacillin to intravenous lipid emulsions which verify this statement. The special case of intravenous emulsions is dealt with in Section 8.7.2. 

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