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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest treatment for pulmonary embolism

Answered by
Dr.
Dr. Divakara

Internal Medicine Specialist

Practicing since :2006

Answered : 2358 Questions

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Posted on Fri, 20 Mar 2015 in Hypertension and Heart Disease
Question: Hello! This is regarding my cousin who is diagnosed with pulmonary embolism (PE). To explain the case, she is a baseket ball player and during the game she collapsed suddenly and was taken to the hospital. It was diagnosed to be a PE case. This was way back in 2010(around 5 years ago). She was given the medication of Loprin, Acitrom, Pulmopress, Razo, Livogen, Xtracal and Dolo as SoS. Probably Pulmopress is the significant drug here for the PE problem. She has used these medicines till 2011 October from Sptember 2010. Which is like a whole one year. She is fine till now and we consulted a doctor recently and certain tests were performed and now she is advised to take PRADAXA 150mg twice daily. I am attaching all the reports of previous hospitalization and the recent consultation. The whole problem here is she is advised to use PRADAXA throughout her life. When we read in the internet we found several dangers with the drug PRADAXA. We are looking for a second opinion and also want to really know what are the DOs and DOnts. Can she be a player again, do trekking, swimming, visit high altitude places, take flight journey etc.? Thanks in advance.
doctor
Answered by Dr. Divakara 23 hours later
Brief Answer:
It has to be taken Life long.

Detailed Answer:
HI

Greetings from Dr.Divakara.P
Thanks for posting your query.

First I will tell you some basics of Pulmonary embolism . It happens due to abnormal clotting of blood inside the blood vessels and this clot travels to lungs and blocks one of the blood vessels supplying blood to lungs thus impairing the blood flow to lungs and causing damage to lungs.

The medicine Praxada is a anti coagulant which reduces the chances of abnormal clotting of blood and in turn reduces the risk of further Pulmonary embolism .

Since the reason for abnormal blood clotting has not yet been found the medicine PRAXADA has to be taken life long .

Yes there are side effects of this medicine especially bleeding risk , but the amount of protection it gives in preventing further recurrence of pulmonary embolism is great and hence needs to be taken .

Regarding don't s :

1. She needs to avoid dehydration. Drink plenty of water.
2. Avoid taking medicines without consulting doctor : As there are lot of medicines that has interactions with PRAXADA that can increase or decrease the efficacy of PRAXADA.

3. Avoid Prolonged standing or prolonged sitting.

She can do any activities that doesn't involve Prolonged standing or prolonged sitting. So travelling by air is not recommended. By it is very essential she needs to use Pneumatic compressive device that keeps pressing and relaxing over her legs.

Hope this information was useful to you.
Any clarification feel free to ask .
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Divakara 1 hour later
Dr Divakara, Thanks for your wonderful explanation. However I would like to know certain things. 1. For around 3 days she is getting temperature in the evenings and lost all her palatability. She is not able to enjoy any food. Does this have anything to do with PE? 2. She also is getting skin rashes and sun burns frequently and is under medication for the same. Will let you know the drugs. Once she is done with that we want to start with Pradaxa. 3. I forgot to mention that she is married. Will there be any gyenic complications with PE or Pradaxa during pregnancy? What kind of precautions should be taken during pregnancy? 4. Can she do high intensity workouts? 5. Where can we get Pradaxa in a reasonable deal as she has to take it for the entire life. Thanks in advance.
doctor
Answered by Dr. Divakara 3 hours later
Brief Answer:
Symptoms not suggestive of PE

Detailed Answer:
HI

Thanks for the follow up .

Fever and loss of appetite are not symptoms of Pulmonary Embolism . It could be a Viral or bacterial infection . Just give her Paracetamol and see for 2 days . If fever is persisting then she may require certain tests and also a course of Antibiotics.

There are no significant gynaecological complications except for excess menstrual bleeding ( which may or may not happen ) Regarding pregnancy this medicine should not be used during pregnancy. If she is planning for pregnancy this medicine has to be changed.

Regarding availability of this medicine at reasonable price presently I don't have any information . But I shall enquire and let you know in 3-4 days.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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