Venous thromboembolism approach

FIGURE 7-1. Venous circulation. (Reproduced from Haines ST, Zeolla M, Witt DM. Venous thromboembolism. In DiPiro JT, Talbert RL, Yee GC, et al, (eds.) Pharmacotherapy A Pathophysiologic Approach. 6th ed. New York McGraw-Hill 2005 374, with permission.)... 

FIGURE 7-5. Treatment approach for patients with VTE. INR, International Normalized Ratio IV, intravenous LMWH, low-molecular-weight heparin PO, oral SC, subcutaneous UFH, unfractionated heparin VTE, venous thromboembolism. (Adapted from Nutescu EA. Emerging options in the treatment of venous thromboembolism. Am J Health Syst Pharm 2004 61 (Suppl 7) S16, with permission.)... 

APPROACH TO TREATING PATIENTS WITH VENOUS THROMBOEMBOLISM... 

Patients with acute stroke should be monitored intensely for the development of neurologic worsening, complications, and adverse effects from treatments. The most common reasons for clinical deterioration in stroke patients are (1) extension of the original lesion in the brain (2) development of cerebral edema and raised intracranial pressure (3) hypertensive emergency (4) infection (e.g., urinary and respiratory tract) (5) venous thromboembolism (6) electrolyte abnormalities and rhythm disturbances and (7) recurrent stroke. The approach to monitoring stroke patients is summarized in Table 13-3. 

Untreated, HIT can lead to thrombosis, venous thromboembolism, acute MI, peripheral artery occlusion, and stroke mortality rate approaches 20% to 30%... 

Nondrug therapeutic approaches for hypertension in pregnancy traditionally have focused on activity restriction, psychosocial therapy, and biofeedback. There is currently no evidence that any of these approaches improves pregnancy outcome, and prolonged bed rest may increase a pregnant woman s risk of venous thromboembolic disease. 

Cardiovascular diseases, comprising acute myocardial infarction, stroke, and venous thromboembolism, have, as their immediate underlying cause, thrombosis of critically situated blood vessels with loss of blood flow to vital organs. One approach to the treatment of thrombosis consists of pharmacologic dissolution of the blood clot via the intravenous infusion of plasminogen activators that activate the blood fibrinolytic system. 

Haas S. Oral direct thrombin inhibition an effective and novel approach for venous thromboembolism. Drugs 2004 64 73-16S. 

Bick RL. Proficient and cost-effective approaches for the prevention and treatment of venous thrombosis and thromboembolism. Drugs 2000 60 575-595. 

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