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wikitox:3.4.1_adjunctive_therapy [2018/09/01 09:00] (current)
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|+||====== 3.4.1 Adjunctive Therapy ======|
|+||A substantial proportion of the in-hospital deaths from poisoning are due to pulmonary emboli. This is a reflection of both the very low death rate from drug toxicity itself (0.6% at our centre) and the fact that these patients are often deeply unconscious for some time (before and after admission).|
|+||[[:wikitox:3.4.15_rhabdomyolysis|Rhabdomyolysis]] is an indication that deep venous thrombosis is likely, but it is unclear if the risk is directly increased or whether rhabdomyolysis is merely a marker for a prolonged period without movement.|
|+||In the absence of [[:wikitox:relative_contraindications_to_anticoagulation|contraindications]], we recommend prophylactic dose low molecular weight heparin (e.g. enoxaparin 40 mg daily) for all patients with sedation sufficient to require ventilation or observation in intensive care.|
|+||Full heparinisation (e.g. enoxaparin 1 mg/kg twice daily) is recommended for patients with rhabdomyolysis, pressure areas or previous thromboembolic disease.|