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PULMONARY EMBOLISM and Ambien

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PULMONARY EMBOLISM Symptoms and Causes

What is a pulmonary embolism (PE)?

A pulmonary embolism (PE) is a sudden blockage in a lung artery. It usually happens when a when a blood clot breaks loose and travels through the bloodstream to the lungs. PE is a serious condition that can cause

  • Permanent damage to the lungs
  • Low oxygen levels in your blood
  • Damage to other organs in your body from not getting enough oxygen

PE can be life-threatening, especially if a clot is large, or if there are many clots.

What causes a pulmonary embolism (PE)?

The cause is usually a blood clot in the leg called a deep vein thrombosis that breaks loose and travels through the bloodstream to the lung.

Who is at risk for a pulmonary embolism (PE)?

Anyone can get a pulmonary embolism (PE), but certain things can raise your risk of PE:

  • Having surgery, especially joint replacement surgery
  • Certain medical conditions, including
    • Cancers
    • Heart diseases
    • Lung diseases
    • A broken hip or leg bone or other trauma
  • Hormone-based medicines, such as birth control pills or hormone replacement therapy
  • Pregnancy and childbirth. The risk is highest for about six weeks after childbirth.
  • Not moving for long periods, such as being on bed rest, having a cast, or taking a long plane flight
  • Age. Your risk increases as you get older, especially after age 40.
  • Family history and genetics. Certain genetic changes that can increase your risk of blood clots and PE.
  • Obesity
What are the symptoms of a pulmonary embolism (PE)?

Half the people who have pulmonary embolism have no symptoms. If you do have symptoms, they can include shortness of breath, chest pain or coughing up blood. Symptoms of a blood clot include warmth, swelling, pain, tenderness and redness of the leg.

How is a pulmonary embolism (PE) diagnosed?

It can be difficult to diagnose PE. To make a diagnosis, your health care provider will

  • Take your medical history, including asking about your symptoms and risk factors for PE
  • Do a physical exam
  • Run some tests, including various imaging tests and possibly some blood tests
What are the treatments for a pulmonary embolism (PE)?

If you have PE, you need medical treatment right away. The goal of treatment is to break up clots and help keep other clots from forming. Treatment options include medicines and procedures.

Medicines

  • Anticoagulants, or blood thinners, keep blood clots from getting larger and stop new clots from forming. You might get them as an injection, a pill, or through an I.V. (intravenous). They can cause bleeding, especially if you are taking other medicines that also thin your blood, such as aspirin.
  • Thrombolytics are medicines to dissolve blood clots. You may get them if you have large clots that cause severe symptoms or other serious complications. Thrombolytics can cause sudden bleeding, so they are used if your PE is serious and may be life-threatening.

Procedures

  • Catheter-assisted thrombus removal uses a flexible tube to reach a blood clot in your lung. Your health care provider can insert a tool in the tube to break up the clot or to deliver medicine through the tube. Usually you will get medicine to put you to sleep for this procedure.
  • A vena cava filter may be used in some people who cannot take blood thinners. Your health care provider inserts a filter inside a large vein called the vena cava. The filter catches blood clots before they travel to the lungs, which prevents pulmonary embolism. But the filter does not stop new blood clots from forming.
Can pulmonary embolism (PE) be prevented?

Preventing new blood clots can prevent PE. Prevention may include

  • Continuing to take blood thinners. It's also important to get regular checkups with your provider, to make sure that the dosage of your medicines is working to prevent blood clots but not causing bleeding.
  • Heart-healthy lifestyle changes, such as heart-healthy eating, exercise, and, if you smoke, quitting smoking
  • Using compression stockings to prevent deep vein thrombosis (DVT)
  • Moving your legs when sitting for long periods of time (such as on long trips)
  • Moving around as soon as possible after surgery or being confined to a bed

NIH: National Heart, Lung, and Blood Institute

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PULMONARY EMBOLISM Clinical Trials and Studies

Treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Clinical trials can also look at other aspects of care, such as improving the quality of life for people with chronic illnesses. People participate in clinical trials for a variety of reasons. Healthy volunteers say they participate to help others and to contribute to moving science forward. Participants with an illness or disease also participate to help others, but also to possibly receive the newest treatment and to have the additional care and attention from the clinical trial staff.
Rank Status Study
1 Not yet recruiting A Comparison of Midazolam and Zolpidem as Oral Premedication in Children
Conditions: Parental/Caregiver Anxiety;   Child's Anxiety
Interventions: Drug: zolpidem;   Drug: Midazolam
Outcome Measures: Patient anxiety at the time of separation;   Other comparison measures will include preoperative parent/caregiver anxiety, anesthesia mask acceptance characteristics at the time of induction, and time to full recovery in the post operative period.
2 Recruiting Imaging the Effects of Zolpidem and Alprazolam in Healthy Volunteers at 3T
Condition: Psychotropic Drugs Effects
Interventions: Drug: Zolpidem;   Drug: Alprazolam;   Drug: Caffeine;   Other: Placebo
Outcome Measures: Change in blood oxygen level-dependent (BOLD) signal as measured with fMRI;   Change in subjective drug effects as measured by self-report questionnaires
3 Recruiting Effects of Zolpidem CR® in Sleep and Heart Recovery in Cardiac Intensive Care Unit Patients
Conditions: Acute Coronary Syndrome;   Sleep Deprivation
Interventions: Drug: Zolpidem CR 12.5mg;   Drug: Placebo
Outcome Measures: Sleep efficiency;   Troponin T;   Creatine-kinase MB
4 Unknown  The Role of Partial Reinforcement in the Long Term Management of Insomnia
Condition: Primary Insomnia
Intervention: Drug: Zolpidem
Outcome Measures: sleep diary;   Sleep Diary
5 Recruiting The Role of Sleep in the Treatment of Cannabis Use Disorders
Condition: Drug Addiction
Interventions: Drug: Zolpidem extended-release;   Behavioral: MET/CBT
Outcome Measures: Sleep Efficiency;   Cannabis Abstinence
6 Recruiting Reducing Suicidal Ideation Through Insomnia Treatment
Conditions: Insomnia;   Depression;   Suicidal Ideation
Interventions: Drug: Zolpidem-CR;   Drug: Placebo
Outcome Measures: Suicide Severity Index (SSI);   Dysfunctional Beliefs and Attitudes About Sleep;   Disturbing Dreams and Nightmares Severity Index (DDNSI);   Beck Hopelessness Scale (BHS);   Hamilton Rating Scale for Depression (HAM-D);   Insomnia Severity Index (ISI)
7 Not yet recruiting Polysomnographic Study Comparing the Use of Dexmedetomidine and Zolpidem to Induce Natural Sleep
Condition: Insomnia
Interventions: Drug: Dexmedetomidine;   Drug: Zolpidem;   Drug: Oral Placebo;   Drug: Normal Saline placebo.
Outcome Measures: Subjective and objective measures of sleep quality;   Performance on a word-pair cognitive task after waking up from sleep
8 Recruiting Effect of a Hypocretin/Orexin Antagonist on Neurocognitive Performance
Condition: Healthy Volunteers
Interventions: Drug: Almorexant;   Drug: Zolpidem 10mg;   Drug: Placebo
Outcome Measure: A comparison between dosing groups on performance on neurocognitive measures
9 Recruiting Alternative Dosing Regimens in the Pharmacotherapy of Insomnia
Condition: Insomnia
Interventions: Drug: Amitriptyline;   Drug: Zolpidem;   Drug: Placebo
Outcome Measures: Objective Total Sleep Time;   Objective Sleep Onset Latency;   Self-reported Total Sleep Time;   Self-Reported Sleep Onset Latency;   Percentage of REM sleep;   REM onset latency;   Objective Sleep Efficiency;   Self-Reported Total Sleep Time;   Self-reported Sleep Onset Latency (min);   Self-reported Sleep Onset Latency (evaluation)
10 Unknown  Risperidone and Zotepine in the Treatment of Delirium
Condition: Delirium
Intervention: Drug: Risperidone and Zolpidem for delirium
Outcome Measures: Delirium rating scale;   MMSE, CGI, side effect profile, HRV
11 Unknown  Memory Consolidation in Pharmacologically Enhanced Naps
Condition: Sleep
Interventions: Drug: Low-dose sodium oxybate;   Drug: High-dose sodium oxybate;   Drug: Low-dose zolpidem;   Drug: High-dose zolpidem;   Drug: Placebo
Outcome Measures: Pharmacological enhancement of specific sleep parameters in a dose-dependent manner;   Correlation of pharmacological interventions with changes in sleep-stage-specific memory tasks
12 Unknown  Age-Dependent Memory Benefits From Pharmacologically Enhanced Naps?
Condition: Older Adults
Interventions: Drug: Sodium Oxybate;   Drug: Zolpidem;   Drug: placebo
Outcome Measure:
13 Recruiting Sequenced Therapies for Comorbid and Primary Insomnias
Conditions: Insomnia Comorbid to Psychiatric Disorder;   Primary Insomnia
Interventions: Behavioral: Behavioral Insomnia Therapy;   Drug: Zolpidem;   Drug: Trazodone;   Behavioral: Cognitive Therapy
Outcome Measure: Insomnia Severity Index- Change from Baseline (Remission)
14 Recruiting Use of Benzodiazepines and Z Drugs in the Elderly
Condition: Chronic Benzodiazepines and Related Drugs Users
Intervention:
Outcome Measures: Dependence according to DSM IV criteria;   withdrawal syndrome;   psychiatric comorbidities;   Dependence scores
15 Not yet recruiting Effects of GABA Modulator AZD7325 on Cortical Excitability
Condition: Healthy
Interventions: Drug: 2 mg AZD7325;   Drug: 10 mg AZD7325;   Drug: Placebo
Outcome Measures: Change in conventional measure of percentage short interval intracortical inhibition (SICI) at an interstimulus interval (ISI) of 2.5 ms and conditioning stimulus intensity of 70 percent of resting motor threshold;   Change in the variables of kinematic analysis of circle drawing;   Change in the rating on a 0-100 mm Visual Analogue Scale (VAS) of degree of sedation and the score of Symbol Digit Modalities Test (SDMT);   Safety and tolerability of a single dose of AZD7325 by assessment of adverse events, vital signs, physical examination, ECG, and laboratory variables
16 Recruiting Effects of Hallucinogens and Other Drugs on Mood and Performance
Condition: Healthy
Intervention: Drug: Hallucinogens and psychoactive substances
Outcome Measures: Rating of "Drug Liking" on the End of Day Questionnaire;   Hallucinogen Rating Scale