RT Book, Section
A1 Zehnder, James L.
A2 Katzung, Bertram G.
SR Print(0)
ID 1148438072
T1 Drugs Used in Disorders of Coagulation
T2 Basic & Clinical Pharmacology, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259641152
LK accesspharmacy.mhmedical.com/content.aspx?aid=1148438072
RD 2024/04/16
AB CASE  STUDYA  25-year-old  woman  presents  to  the  emergency  department  complaining  of  acute  onset  of  shortness  of  breath  and  pleuritic  pain.  She  had  been  in  her  usual  state  of  health  until  2  days  prior  when  she  noted  that  her  left  leg  was  swollen  and  red.  Her  only  medication  was  oral  contraceptives.  Family  history  was  significant  for  a  history  of  “blood  clots”  in  multiple  members  of  the  maternal  side  of  her  family.  Physical  examination  demonstrates  an  anxious  woman  with  stable  vital  signs.  The  left  lower  extremity  demonstrates  erythema  and  edema  and  is  tender  to  touch.  Oxygen  saturation  by  fingertip  pulse  oximeter  while  breathing  room  air  is  87%  (normal  >  90%).  Ultrasound  reveals  a  deep  vein  thrombosis  in  the  left  lower  extremity;  chest  computed  tomography  scan  confirms  the  presence  of  pulmonary  emboli.  Laboratory  blood  tests  indicate  elevated  D-dimer  levels.  What  therapy  is  indicated  acutely?  What  are  the  long-term  therapy  options?  How  long  should  she  be  treated?  Should  this  individual  use  oral  contraceptives?