Loading…

Lesson of the month 2: Pulmonary embolism in a patient on rivaroxaban and concurrent carbamazepine

A 71-year-old female with a history of pulmonary embolism treated with rivaroxaban presented with acute onset shortness of breath, chest pain and palpitations. Computed tomographic pulmonary angiography (CTPA) revealed multiple bilateral pulmonary emboli. The patient was concurrently prescribed carb...

Full description

Saved in:

Bibliographic Details
Published in:	Clinical medicine (London, England) England), 2018-02, Vol.18 (1), p.103-105
Main Authors:	Burden, Thomas, Thompson, Charlotte, Bonanos, Efstathios, Medford, Andrew RL
Format:	Article
Language:	English
Subjects:	Anticoagulants Breast cancer carbamazepine Cardiac arrhythmia CYP3A4 direct oral anticoagulants Drug dosages drug interactions Embolisms Enzymes Family medical history Health risk assessment Heart Lesson of the Month Lymphatic system NMR Nuclear magnetic resonance Pulmonary arteries Pulmonary embolism Pulmonary embolisms rivaroxaban Thromboembolism Thrombosis
Citations:	Items that this one cites Items that cite this one
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

cited_by	cdi_FETCH-LOGICAL-c495t-c78d10bd85d355304f198e8aff1d6625dfe4e23584b00f84cb0cfe75394c6d193
cites	cdi_FETCH-LOGICAL-c495t-c78d10bd85d355304f198e8aff1d6625dfe4e23584b00f84cb0cfe75394c6d193
container_end_page	105
container_issue	1
container_start_page	103
container_title	Clinical medicine (London, England)
container_volume	18
creator	Burden, Thomas Thompson, Charlotte Bonanos, Efstathios Medford, Andrew RL
description	A 71-year-old female with a history of pulmonary embolism treated with rivaroxaban presented with acute onset shortness of breath, chest pain and palpitations. Computed tomographic pulmonary angiography (CTPA) revealed multiple bilateral pulmonary emboli. The patient was concurrently prescribed carbamazepine and was later diagnosed with recurrence of breast cancer during the admission. We discuss common drug interactions pertinent to direct oral anticoagulants (DOACs) that can increase the risk of further venous thromboembolism. This case report highlights the importance of reviewing patient medications when considering anticoagulants and the need to raise awareness of these drug interactions among clinicians when making their choice of anticoagulation. It also reinforces the current lack of evidence for use of DOACs in patients with solid organ malignancies.
doi_str_mv	10.7861/clinmedicine.18-1-103
format	article
fullrecord	<record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6330908</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1470211824012661</els_id><sourcerecordid>2035228667</sourcerecordid><originalsourceid>FETCH-LOGICAL-c495t-c78d10bd85d355304f198e8aff1d6625dfe4e23584b00f84cb0cfe75394c6d193</originalsourceid><addsrcrecordid>eNqFUUtLHTEUDkWpj_YnFAKuxyaTx2RcVETaWrigC7sOmeSkNzKT3CYzF_XXG3tF6spVDnyPfOc7CH2h5LRTkn61Y4gTuGBDhFOqGtpQwj6gQ8o71nDVs71_M2laStUBOirljhAqeC8_ooO250xyQQ7RsIJSUsTJ43kNeEpxXuP2DN8sY51NfsAwDWkMZcIhYoM3Zg4QZ1wlOWxNTvdmMBWIDtsU7ZLzM2pNHsxkHmFT031C-96MBT6_vMfo94_vt5dXzer656_Li1VjeS_mxnbKUTI4JRwTghHuaa9AGe-pk7IVzgOHlgnFB0K84nYg1kMnWM-tdLRnx-jbznezDLUZW4NkM-pNDlPdQycT9FskhrX-k7ZaMkZ6oqrByYtBTn8XKLO-S0uONbNuCRNtq6TsKkvsWDanUjL41x8o0c-n0f-fRlOlaUVY1Z3vdFA72AbIuthapa3EDHbWLoV3HJ4Aj3mcrA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2035228667</pqid></control><display><type>article</type><title>Lesson of the month 2: Pulmonary embolism in a patient on rivaroxaban and concurrent carbamazepine</title><source>ScienceDirect®</source><source>PubMed Central</source><creator>Burden, Thomas ; Thompson, Charlotte ; Bonanos, Efstathios ; Medford, Andrew RL</creator><creatorcontrib>Burden, Thomas ; Thompson, Charlotte ; Bonanos, Efstathios ; Medford, Andrew RL</creatorcontrib><description>A 71-year-old female with a history of pulmonary embolism treated with rivaroxaban presented with acute onset shortness of breath, chest pain and palpitations. Computed tomographic pulmonary angiography (CTPA) revealed multiple bilateral pulmonary emboli. The patient was concurrently prescribed carbamazepine and was later diagnosed with recurrence of breast cancer during the admission. We discuss common drug interactions pertinent to direct oral anticoagulants (DOACs) that can increase the risk of further venous thromboembolism. This case report highlights the importance of reviewing patient medications when considering anticoagulants and the need to raise awareness of these drug interactions among clinicians when making their choice of anticoagulation. It also reinforces the current lack of evidence for use of DOACs in patients with solid organ malignancies.</description><identifier>ISSN: 1470-2118</identifier><identifier>EISSN: 1473-4893</identifier><identifier>DOI: 10.7861/clinmedicine.18-1-103</identifier><identifier>PMID: 29436450</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>Anticoagulants ; Breast cancer ; carbamazepine ; Cardiac arrhythmia ; CYP3A4 ; direct oral anticoagulants ; Drug dosages ; drug interactions ; Embolisms ; Enzymes ; Family medical history ; Health risk assessment ; Heart ; Lesson of the Month ; Lymphatic system ; NMR ; Nuclear magnetic resonance ; Pulmonary arteries ; Pulmonary embolism ; Pulmonary embolisms ; rivaroxaban ; Thromboembolism ; Thrombosis</subject><ispartof>Clinical medicine (London, England), 2018-02, Vol.18 (1), p.103-105</ispartof><rights>2018 © Royal College of Physicians 2018. All rights reserved.</rights><rights>Copyright Royal College of Physicians Feb 2018</rights><rights>Royal College of Physicians 2018. All rights reserved. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c495t-c78d10bd85d355304f198e8aff1d6625dfe4e23584b00f84cb0cfe75394c6d193</citedby><cites>FETCH-LOGICAL-c495t-c78d10bd85d355304f198e8aff1d6625dfe4e23584b00f84cb0cfe75394c6d193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330908/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1470211824012661$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,3548,27923,27924,45779,53790,53792</link.rule.ids></links><search><creatorcontrib>Burden, Thomas</creatorcontrib><creatorcontrib>Thompson, Charlotte</creatorcontrib><creatorcontrib>Bonanos, Efstathios</creatorcontrib><creatorcontrib>Medford, Andrew RL</creatorcontrib><title>Lesson of the month 2: Pulmonary embolism in a patient on rivaroxaban and concurrent carbamazepine</title><title>Clinical medicine (London, England)</title><description>A 71-year-old female with a history of pulmonary embolism treated with rivaroxaban presented with acute onset shortness of breath, chest pain and palpitations. Computed tomographic pulmonary angiography (CTPA) revealed multiple bilateral pulmonary emboli. The patient was concurrently prescribed carbamazepine and was later diagnosed with recurrence of breast cancer during the admission. We discuss common drug interactions pertinent to direct oral anticoagulants (DOACs) that can increase the risk of further venous thromboembolism. This case report highlights the importance of reviewing patient medications when considering anticoagulants and the need to raise awareness of these drug interactions among clinicians when making their choice of anticoagulation. It also reinforces the current lack of evidence for use of DOACs in patients with solid organ malignancies.</description><subject>Anticoagulants</subject><subject>Breast cancer</subject><subject>carbamazepine</subject><subject>Cardiac arrhythmia</subject><subject>CYP3A4</subject><subject>direct oral anticoagulants</subject><subject>Drug dosages</subject><subject>drug interactions</subject><subject>Embolisms</subject><subject>Enzymes</subject><subject>Family medical history</subject><subject>Health risk assessment</subject><subject>Heart</subject><subject>Lesson of the Month</subject><subject>Lymphatic system</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Pulmonary arteries</subject><subject>Pulmonary embolism</subject><subject>Pulmonary embolisms</subject><subject>rivaroxaban</subject><subject>Thromboembolism</subject><subject>Thrombosis</subject><issn>1470-2118</issn><issn>1473-4893</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNqFUUtLHTEUDkWpj_YnFAKuxyaTx2RcVETaWrigC7sOmeSkNzKT3CYzF_XXG3tF6spVDnyPfOc7CH2h5LRTkn61Y4gTuGBDhFOqGtpQwj6gQ8o71nDVs71_M2laStUBOirljhAqeC8_ooO250xyQQ7RsIJSUsTJ43kNeEpxXuP2DN8sY51NfsAwDWkMZcIhYoM3Zg4QZ1wlOWxNTvdmMBWIDtsU7ZLzM2pNHsxkHmFT031C-96MBT6_vMfo94_vt5dXzer656_Li1VjeS_mxnbKUTI4JRwTghHuaa9AGe-pk7IVzgOHlgnFB0K84nYg1kMnWM-tdLRnx-jbznezDLUZW4NkM-pNDlPdQycT9FskhrX-k7ZaMkZ6oqrByYtBTn8XKLO-S0uONbNuCRNtq6TsKkvsWDanUjL41x8o0c-n0f-fRlOlaUVY1Z3vdFA72AbIuthapa3EDHbWLoV3HJ4Aj3mcrA</recordid><startdate>201802</startdate><enddate>201802</enddate><creator>Burden, Thomas</creator><creator>Thompson, Charlotte</creator><creator>Bonanos, Efstathios</creator><creator>Medford, Andrew RL</creator><general>Elsevier Ltd</general><general>Royal College of Physicians</general><scope>6I.</scope><scope>AAFTH</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>EHMNL</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>201802</creationdate><title>Lesson of the month 2: Pulmonary embolism in a patient on rivaroxaban and concurrent carbamazepine</title><author>Burden, Thomas ; Thompson, Charlotte ; Bonanos, Efstathios ; Medford, Andrew RL</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c495t-c78d10bd85d355304f198e8aff1d6625dfe4e23584b00f84cb0cfe75394c6d193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Anticoagulants</topic><topic>Breast cancer</topic><topic>carbamazepine</topic><topic>Cardiac arrhythmia</topic><topic>CYP3A4</topic><topic>direct oral anticoagulants</topic><topic>Drug dosages</topic><topic>drug interactions</topic><topic>Embolisms</topic><topic>Enzymes</topic><topic>Family medical history</topic><topic>Health risk assessment</topic><topic>Heart</topic><topic>Lesson of the Month</topic><topic>Lymphatic system</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Pulmonary arteries</topic><topic>Pulmonary embolism</topic><topic>Pulmonary embolisms</topic><topic>rivaroxaban</topic><topic>Thromboembolism</topic><topic>Thrombosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Burden, Thomas</creatorcontrib><creatorcontrib>Thompson, Charlotte</creatorcontrib><creatorcontrib>Bonanos, Efstathios</creatorcontrib><creatorcontrib>Medford, Andrew RL</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>UK & Ireland Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical medicine (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Burden, Thomas</au><au>Thompson, Charlotte</au><au>Bonanos, Efstathios</au><au>Medford, Andrew RL</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lesson of the month 2: Pulmonary embolism in a patient on rivaroxaban and concurrent carbamazepine</atitle><jtitle>Clinical medicine (London, England)</jtitle><date>2018-02</date><risdate>2018</risdate><volume>18</volume><issue>1</issue><spage>103</spage><epage>105</epage><pages>103-105</pages><issn>1470-2118</issn><eissn>1473-4893</eissn><abstract>A 71-year-old female with a history of pulmonary embolism treated with rivaroxaban presented with acute onset shortness of breath, chest pain and palpitations. Computed tomographic pulmonary angiography (CTPA) revealed multiple bilateral pulmonary emboli. The patient was concurrently prescribed carbamazepine and was later diagnosed with recurrence of breast cancer during the admission. We discuss common drug interactions pertinent to direct oral anticoagulants (DOACs) that can increase the risk of further venous thromboembolism. This case report highlights the importance of reviewing patient medications when considering anticoagulants and the need to raise awareness of these drug interactions among clinicians when making their choice of anticoagulation. It also reinforces the current lack of evidence for use of DOACs in patients with solid organ malignancies.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><pmid>29436450</pmid><doi>10.7861/clinmedicine.18-1-103</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record>
fulltext	fulltext
identifier	ISSN: 1470-2118
ispartof	Clinical medicine (London, England), 2018-02, Vol.18 (1), p.103-105
issn	1470-2118 1473-4893
language	eng
recordid	cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6330908
source	ScienceDirect®; PubMed Central
subjects	Anticoagulants Breast cancer carbamazepine Cardiac arrhythmia CYP3A4 direct oral anticoagulants Drug dosages drug interactions Embolisms Enzymes Family medical history Health risk assessment Heart Lesson of the Month Lymphatic system NMR Nuclear magnetic resonance Pulmonary arteries Pulmonary embolism Pulmonary embolisms rivaroxaban Thromboembolism Thrombosis
title	Lesson of the month 2: Pulmonary embolism in a patient on rivaroxaban and concurrent carbamazepine
url	http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T11%3A04%3A22IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Lesson%20of%20the%20month%202:%20Pulmonary%20embolism%20in%20a%20patient%20on%20rivaroxaban%20and%20concurrent%20carbamazepine&rft.jtitle=Clinical%20medicine%20(London,%20England)&rft.au=Burden,%20Thomas&rft.date=2018-02&rft.volume=18&rft.issue=1&rft.spage=103&rft.epage=105&rft.pages=103-105&rft.issn=1470-2118&rft.eissn=1473-4893&rft_id=info:doi/10.7861/clinmedicine.18-1-103&rft_dat=%3Cproquest_pubme%3E2035228667%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c495t-c78d10bd85d355304f198e8aff1d6625dfe4e23584b00f84cb0cfe75394c6d193%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2035228667&rft_id=info:pmid/29436450&rfr_iscdi=true