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Massive Pulmonary Embolism - #PHARMFAX

Pulmonary embolisms are obstructions of the pulmonary artery from a thrombus that typically travel from your lower extremities.

 

Pulmonary embolisms are obstructions of the pulmonary artery from a thrombus that typically travel from your lower extremities. Occlusions cause right heart strain and gas exchange abnormalities, leading to hemodynamic instability and shock. We’ve got a patient crashing from a massive pulmonary embolism, maxed on supplemental oxygen with increasing norepinephrine rates. Thrombolytics break down clots, improves pulmonary perfusion and gas exchange. We’ll give alteplase 100 mg IV total over 2 hours for massive pulmonary embolisms. Theres limited benefit for intermediate PEs with increased risk of bleeding. For extensive clot burden or contraindications to systemic thrombolysis, thrombectomy and catheter-direct thrombolysis are considered. In the setting of cardiac arrest, we’ll give alteplase 50 mg IV up to 2 doses. Give the drug enough time to work. Thanks for tuning in, share the #PHARMFAX with a friend, and I hope you learned something new.


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Not medical advice. Educational purposes only. No relationships to report. I hope you learned something new.

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