Definition
Pulmonary embolism refers to a complex morbid condition caused by an embolus in which one or more arteries in the lungs are obstructed; pulmonary embolism must be promptly treated with drugs, which are essential to reduce the risk of death. Untreated pulmonary embolism can give fatal results.
Causes
Among the causes most involved in the onset of pulmonary embolism, the blood clot plays a leading role; pulmonary embolism represents a direct complication of deep vein thrombosis. Among the other etiological elements, we recall: accumulations of fat, air bubbles and parts of neoplasias which, carried by the blood, reach an area of a pulmonary artery, obstructing it.
Risk factors: diseases inheriting blood, overweight, obesity, pregnancy, childbirth, birth control pills, smoking
Symptoms
The symptoms of pulmonary embolism can be very different in terms of intensity and type; in fact, they depend essentially on the caliber of the obstructed pulmonary vessel: altered heart rate, difficulty breathing, chest pain, bloody sputum, swollen legs, weak pulse, fainting, excessive sweating and coughing.
Information on Pulmonary Embolism - Drugs for the Treatment of Pulmonary Embolism is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Pulmonary Embolism - Pulmonary Embolism Drugs.
drugs
As mentioned, the pharmacological treatment of pulmonary embolism is essential for the patient's recovery; moreover, taking medications reduces the risk of serious complications and death of the subject. The pharmacological treatment of pulmonary embolism involves the arrest of the formation of the clot, ensures the oxygenation of the blood, breaks the thrombus created, prevents the onset of recurrences and ensures a stable arterial pressure, within the physiological ranges.
Thrombolytics : these drugs are used in therapy to damage the thrombus created. It should be pointed out that these drugs can cause bleeding, therefore they are prescribed only in patients who are unstable from a haemodynamic point of view.
- Streptokinase: it is recommended to take the drug for the treatment of pulmonary embolism, at a dose of 250, 000 units in 30 minutes, by intravenous infusion; then, inject 100, 000 units / hour for 12-72 hours, depending on the patient's health conditions, his response to the treatment and the coagulation parameters.
- Urokinase (eg Urochinase Crinos, Urokinasi HSP) initiate therapy with 4, 400 units per kilo, administered by bolus infusion, in 10 minutes. Continue with 4, 400 units / kg every hour, administered intravenously continuously for 12 hours.
- Alteplase (tissue plasminogen activator. Es: Actilyse) administer 10 mg of drug by intravenous injection in 1-2 minutes; subsequently, continue therapy by injecting 90 mg of drug in 2 hours. Do not exceed 1.5 mg / kg in subjects weighing less than 65 kilos.
Selective factor Xa inhibitors
Fondaparinux sodium (eg Arixtra): for the treatment of pulmonary embolism, it is possible to take doses of 5 - 7.5 and 10 mg, based on the weight of the patient. The drug is administered subcutaneously once a day, in combination with warfarin: the combination of these drugs must be started no later than 72 hours after the onset of symptoms. The treatment should be continued for 5 days or so that the effect given by an anticoagulant drug stabilizes the symptoms; it is possible to prolong therapy up to 26 days. Consult your doctor.
Blood thinners or anticoagulants : useful for stopping / inhibiting blood clots
- Warfarin (eg. Coumadin): in the case of drug treatment with warfarin it is the duty of the patient to report the intake, given the multiple interactions with other drugs and the serious side effects it may cause. It is not possible to trace a precise treatment plan concerning the dosage of the drug: this must be established and perfected by the specialist, taking into consideration the functional and hematological abilities of the patient.
However, to give an indicative idea, a therapeutic plan is described below, to be considered exclusively as a guideline. Begin therapy by taking 2-5 mg of warfarin orally or intravenously for 1 or 2 days. Maintenance dose: 2-10 mg of drug to be taken orally or IV, once a day. The duration of therapy varies from 3 to 12 months.
- Heparins (eg. Heparin CAL ACV, Heparin sod. Ath, Ateroclar, Trombolisin): generally administered by continuous infusion for subjects suffering from pulmonary embolism who are hemodynamically stable on diagnostic examination. Administer 5, 000 units of drug by slow intravenous bolus infusion; subsequently, assume 1, 300 units / hour by continuous infusion. Alternatively, take the drug by continuous bolus infusion at a dose of 80 units / kg, followed by 18 units / kilo per hour by continuous intravenous infusion. In case of suspected massive pulmonary embolism, the initial dosage should be 10, 000 units, intravenous bolus administration, followed by 1, 500 units per hour.
Still, alternatively, for the treatment of pulmonary embolism, take 17, 500 units of drug by subcutaneous route every 12 hours. The dosage must be carefully monitored.
Oxygen therapy : this therapy is recommended only in patients suffering from mild or moderate forms of pulmonary embolism. Oxygen therapy reduces the risk of hypoventilation and carbon dioxide retention.
Notes: When the pulmonary embolus is too large, the drugs do not always carry out their therapeutic activity; therefore it is possible to aspirate the coagulum through a catheter, although this procedure is not always effective.
Alternatively, for a person suffering from pulmonary embolism in case of shock, emergency surgical treatment, the only life-saving conceivable option, may be indispensable.
