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PULMONARY EMBOLISM and Propranolol

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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

Check out the latest treatments for PULMONARY EMBOLISM

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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 Recruiting Safety and Efficacy of Propranolol Eye Drops in Treating Retinopathy of Premature
Condition: Retinopathy of Prematurity
Intervention: Drug: Propranolol eye drops
Outcome Measures: Incidence rate of progression from stage 2 ROP to more severe stage ROP (stage 2 or 3 with plus, stage 4 and stage 5);   Plasma concentrations of Propranolol at the steady state;   Number of newborns who progress to Stage 3 without plus ROP;   Number of newborns who progress to Stage 4 or 5 ROP with total or partial retinal detachment;   Number of newborns who need laser treatment;   Number of newborns who need rescue treatment with bevacizumab;   Number of newborns who need vitrectomy;   Collection of adverse events due to eye drop Propranolol treatment
2 Not yet recruiting Efficacy of Propranolol Treatment to Prevent Melanoma Progression
Conditions: Stages III Skin Melanoma;   Stages II Skin Melanoma;   Stage IB Skin Melanoma
Interventions: Drug: Propranolol hydrochloride;   Drug: Placebo pill
Outcome Measures: Efficacy of Propranolol on progression free survival for patients suffering from a primary melanoma with a high risk of recurrence;   Use of serum microRNA profile as a predictor for recurrence;   Overall survival
3 Recruiting Propanolol and Red Cell Adhesion Non-asthmatic Children Sickle Cell Disease
Condition: Sickle Cell Disease
Intervention: Drug: Propranolol
Outcome Measures: measurement of the sickle red cell response to epinephrine;   Safety data regarding the use of propanolol in children with sickle cell disease
4 Recruiting Study of Propranolol in Newly Diagnosed Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy
Condition: Locally Advanced Breast Cancer
Interventions: Drug: Propranolol;   Other: Breast imaging - Diffuse Optical Tomography (DOT)
Outcome Measures: Percentage of patients who are compliant with taking > 80% take the drug while on chemotherapy.;   Changes in angiogenesis;   Changes in stress levels;   Number of Patients with Adverse Events;   Change in DOT-derived parameters;   Changes in tumor proliferation
5 Unknown  Propranolol Treatment of Traumatic Memories (PTTM)
Conditions: Traumatic Memory;   Posttraumatic Stress Disorder
Interventions: Drug: Propranolol Hydrochloride;   Drug: Placebo
Outcome Measures: The primary endpoint will be changes between the pretreatment and posttreatment scores in the Clinician Assessment Posttraumatic Scale (CAPS), Impact of Event Scale (IES) and Traumatic Memory Description Measure (TMDM) instruments.;   The secondary endpoint will be changes between the treatment and posttreatment score in the other scales used - MINI, ZAS, ZDS and NIHS.
6 Recruiting Perioperative Propranolol in Patients With Post Traumatic Stress Disorder (PTSD)
Condition: Post-traumatic Stress Disorder
Interventions: Drug: Propranolol Hydrochloride;   Other: Placebo
Outcome Measures: ICU length of stay;   Hospital length of stay;   Postoperative delirium;   Postoperative renal dysfunction;   Perioperative complications;   Pain intensity;   Pain unpleasantness;   Analgesics use;   Length of intubation and mechanical ventilation;   Post Traumatic Stress Disorder symptomatology;   Quality of Life;   Functional status;   Sleep Quality;   Depression symptoms;   Postoperative Neurocognitive Dysfunction Score;   30-day, 3-month, and 1-year mortality;   Postoperative complications
7 Recruiting Efficacy of Clonidine and Propranolol in Dentistry (AAA)
Condition: Anxiety
Interventions: Drug: Clonidine;   Drug: Propranolol;   Drug: Placebo
Outcome Measures: Change from baseline in modified dental anxiety scale(MDAS)and vital signs (blood pressure, heart rate, respiratory rate, oxygen saturation) until four hours post treatment;   Changes in Verbal Numerical Rating Scale (VNRS) at three, six, and twenty-four hours post treatment
8 Unknown  Reducing Reconsolidation of Trauma Memories With Propranolol
Condition: Posttraumatic Stress Disorder
Interventions: Drug: Propranolol;   Drug: Short acting + long acting Propranolol + memory reactivation
Outcome Measures: Electromyogram;   Heart rate;   Skin conductance;   PTSD symptom levels;   Quality of life;   Memory Experience;   Psychophysiological assessments
9 Unknown  Endoscopic Band Ligation (EBL) Versus Propranolol for Primary Prophylaxis of Variceal Bleeding
Conditions: Variceal Bleeding;   Cirrhosis
Interventions: Procedure: Endoscopic band ligation;   Drug: Propranolol;   Procedure: endoscopic band ligation and Propranolol
Outcome Measures: First esophageal variceal bleeding;   Mortality; Significant esophageal variceal bleeding; Upper gastrointestinal bleeding except esophageal bleeding; Adverse events
10 Unknown  A Psychophysiologic Study of Weakening Traumatic Combat Memories With Post-Reactivation Propranolol
Condition: Post-Traumatic Stress Disorder
Intervention: Drug: Propranolol
Outcome Measure: Psychophysiologic responses during script-driven imagery of combat events
11 Unknown  A Novel Treatment For Chronic Posttraumatic Stress Disorder (PTSD) Using Post-Reactivation Propranolol
Condition: Stress Disorders, Post-Traumatic
Intervention: Drug: Propranolol is available in generic form as the Wyeth product under the trade name Inderal.
Outcome Measures: Clinician-Administered PTSD Scale (CAPS) for DSM-IV;   Mini International Neuropsychiatric Interview (MINI);   Peritraumatic Distress Inventory (PDI);   The Peritraumatic Dissociative Experiences Questionnaire;   PTSD Check List (PCL) civilian version;   Script-driven imagery psychophysiological measurement
12 Recruiting Propranolol in Severely Burned Children
Condition: Burn
Interventions: Drug: Propranolol;   Drug: Placebo
Outcome Measures: Resting heart rate multiplied by the systolic blood pressure measurement= rate pressure product;   Number of deaths
13 Recruiting Propranolol Versus Prednisolone for Treatment of Symptomatic Hemangiomas
Condition: Hemangioma of Infancy
Interventions: Drug: Propranolol;   Drug: Prednisolone
Outcome Measures: reduction in size of hemangioma;   Tolerability of medication
14 Recruiting The Safety and Efficiency of Propranolol as an Initial Treatment for Pediatric Hemangioma
Condition: Hemangioma
Interventions: Drug: Prednisolone;   Drug: Propranolol
Outcome Measures: Hemangioma volume measured by MRI or SONO;   Size changes from baseline;   Heart rate change from Baseline at 16 weeks;   Change from Baseline in color;   Changes in Size of Ulceration;   Whether or not Re-epithelized in 16weeks;   Stop time of proliferation;   Time of regression;   Drug compliance within 16 weeks;   Change from Baseline in systolic blood pressure at 16 weeks;   Changes from baseline in Glucose level at 16 weeks;   Whether the facial edema occurs within 16 weeks;   Whether growth retardation occurs within 16 weeks;   Whether the Gastroesophageal reflux occurs within 16 weeks;   Number of Participants with Adverse drug reaction
15 Recruiting Protective Effects of Propranolol in Adults
Condition: Burn
Interventions: Drug: Propranolol;   Drug: Placebo
Outcome Measures: Cardiac rate pressure product;   Mortality rates
16 Recruiting Rifaximin and Propranolol Combination Therapy Versus Propranolol Monotherapy in Cirrhotic Patients
Conditions: Liver Cirrhosis;   Portal Hypertension
Interventions: Drug: Rifaximin + Propranolol;   Drug: Propranolol + Placebo
Outcome Measures: Hepatic vein pressure gradient(HVPG);   occurence of gastrointestinal bleeding
17 Recruiting Efficacy and Safety of Propranolol Versus Acebutolol on the Proliferative Phase of Infantile Hemangioma
Condition: Hemangioma
Interventions: Drug: Acebutolol;   Drug: Propanolol
Outcome Measures: Hemangioma size;   Tolerance of treatment;   Proportion of patients requiring treatment with corticosteroids because of the evolution of a 'serious' hemangioma
18 Recruiting Early Propranolol After Traumatic Brain Injury: Phase II
Condition: Traumatic Brain Injury
Intervention: Drug: Propranolol
Outcome Measure: Determine in patients with traumatic brain injury (TBI) the safe dosing of early Propranolol.
19 Unknown  Propranolol for Diabetic Retinopathy
Condition: Proliferative Diabetic Retinopathy
Intervention: Drug: Propranolol
Outcome Measures: Area of retinal neovascularization on fundus photography;   Retinopathy level in contralateral eye;   Optical coherence tomography macular thickness of treated and fellow eye;   Amount of fluorescein leakage on angiography;   Early Treatment Diabetic Retinopathy Study visual acuity in study and fellow eye
20 Recruiting Treatment of PTSD by Reduction of Traumatic Memory Reconsolidation by Propranolol : a Multisite Trial
Condition: Post-traumatic Stress Disorder
Interventions: Drug: Propranolol;   Other: Trauma reactivation;   Drug: placebo
Outcome Measure: PTCD CheckList (PCL) total score.