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wikitox:3.4.1_adjunctive_therapy

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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).
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 +[[:​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.
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 +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.
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 +Full heparinisation (e.g. enoxaparin 1 mg/kg twice daily) is recommended for patients with rhabdomyolysis,​ pressure areas or previous thromboembolic disease.
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