Practical considerations in prevention and treatment of venous thromboembolism in hospitalized patients with COVID-19.

Purpose: There are increasing reports in the literature of high rates of coagulopathy and venous thromboembolism (VTE) among hospitalized patients with coronavirus disease 2019 (COVID-19). Understanding of these abnormalities is continually evolving, but these conditions may pose a risk to patients with COVID-19 beyond the risk typically seen in critically ill patients.

Summary: There are currently no widely accepted evidence-based guidelines regarding specifics related to treatment and prevention of COVID-19-related coagulopathies.

Evidence of a clinically significant interaction between warfarin and intravesical gemcitabine.

Purpose: A case of supratherapeutic International Normalized Ratio (INR) values and hematomas subsequent to concomitant administration of warfarin and intravesical gemcitabine is reported.

Summary: A 90-year-old man with bladder cancer refractory to bacillius Calmette-Guérin was diagnosed with deep vein thrombosis (DVT) and started on warfarin one month before starting treatment with intravesical gemcitabine 2 g (one dose per week for six weeks). Before intravesical gemcitabine was started, the patient reached consecutive therapeutic INR values.

Achievement of therapeutic anti-Xa levels in a proven heparin-resistant patient through the use of nontraditional high-dose enoxaparin.

Objective: To describe the successful use of high-dose enoxaparin therapy (1.5 mg/kg subcutaneously twice daily) to attain a therapeutic anti-factor Xa (anti-Xa) level in a cancer patient with heparin resistance.

Case Summary: A proven heparin-resistant patient with venous thromboembolism (VTE) and lung cancer who required approximately 66 000 units of unfractionated heparin daily was successfully transitioned to an off-label high-dose enoxaparin (OLHDE) 1.

Treatment of refractory trigeminal neuralgia with intravenous phenytoin.

Purpose: The case of a patient who was successfully treated with i.v. phenytoin for an acute exacerbation of refractory trigeminal neuralgia (TN) is reported.