Rivaroxaban for Pulmonary Embolism: One pill and done?

With Dr. Jeff Tabas giving a lecture on the perennially hot topic of pulmonary embolism (PE) at the upcoming UCSF High Risk EM Conference (main link, PDF Brochure) in San Francisco May 22-24, 2013, I thought I would get a sneak peek into his discussion points.

Rivaroxaban for Pulmonary Embolism: One pill and done?
By Prathap Sooriyakumaran, MD and Jeffrey Tabas, MD
UCSF-SFGH Emergency Medicine (more…)

By |2026-06-16T16:01:48-07:00Apr 3, 2013|Cardiovascular, Pulmonary, Tox & Medications|

Mythbuster: No Maximum Dose of Enoxaparin

Venous thromboembolism (VTE) is often treated with low molecular weight heparins (LMWH) such as enoxaparin. For patients with normal renal function, dosing is as follows:
  • Enoxaparin: 1 mg/kg subcutaneously every 12 hours, or 1.5 mg/kg every 24 hours
  • Dalteparin 200 IU/kg subcutaneously once daily
  • Tinzaparin: 175 IU/kg subcutaneously once daily

What about the obese patient? Is there a maximum dose for enoxaparin?

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Ketofol: Is this the “Game Changer” of Procedural Sedation and Analgesia?

When talking about procedural sedation and analgesia, our goal is to minimize pain and anxiety, with the appropriate agent that matches the needs of our patient and the clinical scenario. So what are some qualities of this “ideal agent?”

In a perfect world, it would have:

  • Minimal adverse effects
  • Rapid onset and offset of action
  • Pharmocokinetic predictability across a spectrum of patients

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By |2021-03-01T09:32:06-08:00Mar 20, 2013|Tox & Medications|

Lytics for sub-massive PE: Ready for primetime?

PulmonaryembolismThere was recently a great study published in the American Journal of Cardiology (2012) by Sharifi et al1, questioning whether we should be considering tPA in patients other than those patients with massive pulmonary embolism (PE)? You know the big “Saddle Embolus” we all fear? Well it turns out this is only about 5% of all PEs.

Should we be considering tPA in patients with sub-massive PEs?

(more…)

By |2019-09-10T13:37:21-07:00Mar 13, 2013|Cardiovascular, Pulmonary, Tox & Medications|

Dexmedetomidine (Precedex) as an Adjunct to Benzodiazepines for Ethanol Withdrawal

Sometimes a question is posed on Twitter that generates a great discussion from colleagues ’round the globe. Such was the case for dexmedetomidine. Although benzodiazepines remain the standard of treatment for ethanol withdrawal, particularly seizures and delirium tremens, what’s all the hype about dexmedetomidine?

(more…)

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