Intracranial hemorrhage medical therapy: Difference between revisions

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==Overview==
==Overview==
 
Pharmacologic therapy in patients with intracranial hemorrhage includes the administration of agents to reverse the underlying coagulopathies.
 
==Medical Therapy==
==Medical Therapy==
Pharmacologic therapy in patients with intracranial hemorrhage include:<ref name="CaceresGoldstein2012">{{cite journal|last1=Caceres|first1=J. Alfredo|last2=Goldstein|first2=Joshua N.|title=Intracranial Hemorrhage|journal=Emergency Medicine Clinics of North America|volume=30|issue=3|year=2012|pages=771–794|issn=07338627|doi=10.1016/j.emc.2012.06.003}}</ref>
Pharmacologic therapy in patients with intracranial hemorrhage include:<ref name="CaceresGoldstein2012">{{cite journal|last1=Caceres|first1=J. Alfredo|last2=Goldstein|first2=Joshua N.|title=Intracranial Hemorrhage|journal=Emergency Medicine Clinics of North America|volume=30|issue=3|year=2012|pages=771–794|issn=07338627|doi=10.1016/j.emc.2012.06.003}}</ref>
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**Prothrombin Complex Concentrates (PCCs)
**Prothrombin Complex Concentrates (PCCs)
* Protamine sulfate is another agent that can be used for heparin-induced Intracranial hemorrhage.<ref name="HolstLindblad1994">{{cite journal|last1=Holst|first1=J|last2=Lindblad|first2=B|last3=Bergqvist|first3=D|last4=Garre|first4=K|last5=Nielsen|first5=H|last6=Hedner|first6=U|last7=Østergaard|first7=P B|title=Protamine neutralization of intravenous and subcutaneous low-molecular-weight heparin (tinzaparin, Logiparin™). An experimental investigation in healthy volunteers|journal=Blood Coagulation & Fibrinolysis|volume=5|issue=5|year=1994|pages=795–803|issn=0957-5235|doi=10.1097/00001721-199410000-00018}}</ref>
* Protamine sulfate is another agent that can be used for heparin-induced Intracranial hemorrhage.<ref name="HolstLindblad1994">{{cite journal|last1=Holst|first1=J|last2=Lindblad|first2=B|last3=Bergqvist|first3=D|last4=Garre|first4=K|last5=Nielsen|first5=H|last6=Hedner|first6=U|last7=Østergaard|first7=P B|title=Protamine neutralization of intravenous and subcutaneous low-molecular-weight heparin (tinzaparin, Logiparin™). An experimental investigation in healthy volunteers|journal=Blood Coagulation & Fibrinolysis|volume=5|issue=5|year=1994|pages=795–803|issn=0957-5235|doi=10.1097/00001721-199410000-00018}}</ref>
=====Contraindicated medications=====
{{MedCondContrAbs


|MedCond = Intracranial hemmorhage|Amyl nitrite|Cilostazol|Clopidogrel|Pentoxifylline|Prasugrel|Ticagrelor|Ticlopidine|Vorapaxar|Mannitol}}




Revision as of 17:14, 18 June 2020

Intracranial hemorrhage Microchapters

Patient Information

Overview

Classification

Subdural hematoma
Epidural hematoma
Subarachnoid hemorrhage
Intraventricular hemorrhage
Intraparenchymal hemorrhage

Causes

Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]

Overview

Pharmacologic therapy in patients with intracranial hemorrhage includes the administration of agents to reverse the underlying coagulopathies.

Medical Therapy

Pharmacologic therapy in patients with intracranial hemorrhage include:[1]

  • Hemostatic therapy to correct the underlying coagulopathies. Agents that can be used to achieve this goal may differ based on the oral anticoagulant agent which resulted in the bleeding complications.
  • The following agents can be used for warfarin reversal:[2][3][4]
    • Fresh Frozen Plasma (FFP)
    • Prothrombin Complex Concentrates (PCCs)
  • Protamine sulfate is another agent that can be used for heparin-induced Intracranial hemorrhage.[5]



References

  1. ↑ Caceres, J. Alfredo; Goldstein, Joshua N. (2012). "Intracranial Hemorrhage". Emergency Medicine Clinics of North America. 30 (3): 771–794. doi:10.1016/j.emc.2012.06.003. ISSN 0733-8627.
  2. ↑ Steiner, Thorsten; Rosand, Jonathan; Diringer, Michael (2006). "Intracerebral Hemorrhage Associated With Oral Anticoagulant Therapy". Stroke. 37 (1): 256–262. doi:10.1161/01.STR.0000196989.09900.f8. ISSN 0039-2499.
  3. ↑ Goldstein, Joshua N.; Thomas, Stephen H.; Frontiero, Virginia; Joseph, Annelise; Engel, Chana; Snider, Ryan; Smith, Eric E.; Greenberg, Stephen M.; Rosand, Jonathan (2006). "Timing of Fresh Frozen Plasma Administration and Rapid Correction of Coagulopathy in Warfarin-Related Intracerebral Hemorrhage". Stroke. 37 (1): 151–155. doi:10.1161/01.STR.0000195047.21562.23. ISSN 0039-2499.
  4. ↑ Holland, Lorne; Warkentin, Theodore E.; Refaai, Majed; Crowther, Mark A.; Johnston, Marilyn A.; Sarode, Ravindra (2009). "Suboptimal effect of a three-factor prothrombin complex concentrate (Profilnine-SD) in correcting supratherapeutic international normalized ratio due to warfarin overdose". Transfusion. 49 (6): 1171–1177. doi:10.1111/j.1537-2995.2008.02080.x. ISSN 0041-1132.
  5. ↑ Holst, J; Lindblad, B; Bergqvist, D; Garre, K; Nielsen, H; Hedner, U; Østergaard, P B (1994). "Protamine neutralization of intravenous and subcutaneous low-molecular-weight heparin (tinzaparin, Logiparin™). An experimental investigation in healthy volunteers". Blood Coagulation & Fibrinolysis. 5 (5): 795–803. doi:10.1097/00001721-199410000-00018. ISSN 0957-5235.

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