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🛑Thyroxine in pregnancy
✅During pregnancy, the average thyroxine requirements typically increase by 25-50 mcg.

Patient sneezed during CT scan

Whats the most common sustained arrhythmia ?

Whats ur specialty?

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Metabolic Causes of

Hepatic Encephalopathy (Ammonia)
Hypocalcemia
Hypoglycemia
Hyponatremia
Hypomagnesemia
Hyperthyroidism
Hyperparathyroidism
Vitamin B12 Deficiency

AF increases the risk of:

1️⃣ Death : 2-fold
2️⃣ Stroke: 2.4- fold
3️⃣ MI, Dementia, CKD: 1.5-fold
4️⃣ Heart failure: 5-fold

Uses:
🔹 Acute Ischemic Stroke
🔹 Acute Myocardial Infarction
🔹 Pulmonary Embolism
🔹 Prosthetic Valve Thrombosis
🔹 Central Venous Catheter Occlusion: Used to restore patency of occluded central venous catheters.

Dose:
🔹 Acute Ischemic Stroke: 1 mg/kg IV (maximum 100mg); 10% of the total dose as an initial bolus over 1 minute, with the remainder infused over 60 minutes.
🔹 Acute Myocardial Infarction: 15 mg IV bolus, followed by 0.75 mg/kg over 30 minutes (maximum 50 mg), then 0.5 mg/kg over 60 minutes (maximum 35 mg).
🔹 Pulmonary Embolism: 1-2mg/Kg (Max: 100 mg) IV infused over 2 hours.
🔹 Central Venous Catheter Occlusion: 2 mg per lumen, allowed to dwell for 0.5-2 hours.
🔹 Prosthetic Valve Thrombosis: A low-dose regimen is often used, such as 25 mg over 6 hours or 10-20 mg bolus followed by 10-20 mg over 3-6 hours, depending on clinical response and thrombus size.

Presentation:
🔹 Powder for reconstitution: Available in vials of 50 mg and 100 mg.

Note:
🔹 Mechanism of Action: Alteplase is a recombinant tissue plasminogen activator (rtPA) that converts plasminogen to plasmin, leading to the breakdown of fibrin clots.
🔹 Onset and Duration: Rapid onset within 30 minutes; duration varies depending on the dose and indication.
🔹 Side Effects: bleeding, including intracranial hemorrhage. Other potential side effects include hypotension and allergic reactions.
🔹 Contraindications: Active internal bleeding, recent intracranial or spinal surgery, severe uncontrolled hypertension, and history of hemorrhagic stroke.

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