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Prophylactic cosyntropin after unintentional dural puncture and incidence of post-dural puncture headache and epidural blood patch use: A retrospective cohort study (2019-2022).
Int J Obstet Anesth
November 2024
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. Electronic address:
Background: Cosyntropin has been suggested to decrease the incidence of post-dural puncture headache (PDPH) by increasing the production of cerebrospinal fluid. This study examined the association of prophylactic cosyntropin administration with the incidence of PDPH and its management with an epidural blood patch after an unintentional dural puncture (UDP).
Methods: We conducted a retrospective cohort study of cases with UDP during placement of neuraxial labor analgesia.
Cosyntropin prophylaxis with intrathecal saline: impact on post-dural puncture headache and epidural blood patch.
Anaesthesia
January 2024
Soroka University Medical Center Associated with Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
A 65-Year-Old Man with Bilateral Adrenal Hemorrhage Following Prophylaxis for Postoperative Deep Vein Thrombosis with Rivaroxaban.
Am J Case Rep
September 2023
Department of Cardiology, Al Wakrah Hospital, Hamad Medical Corporation, Doha, Qatar.
BACKGROUND Direct oral anticoagulant (DOAC) agents, such as rivaroxaban, treat and prevent venous thrombosis. Although adrenal hemorrhage due to DOACs has previously been reported, this is a rare condition that can present as an emergency. In this case report, we present a 65-year-old man who recently had bilateral knee arthroplasty and was started on rivaroxaban 10 mg daily for deep vein thrombosis (DVT) prophylaxis following the surgery.
View Article and Find Full Text PDFRole of cosyntropin in the prevention of post-dural puncture headache: a propensity-matched retrospective analysis.
Int J Obstet Anesth
November 2023
Division of Obstetrical Anesthesiology, Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA. Electronic address:
Background: Post-dural puncture headache (PDPH) is a well-documented complication of accidental dural puncture in obstetric patients. Reports have shown successful treatment with adrenocorticotropic hormone (ACTH) but evidence remains low and limited. In this retrospective analysis, we assessed whether prophylactic administration of cosyntropin, a synthetic derivative of ACTH, reduced the incidence of PDPH after accidental dural puncture in parturients.
View Article and Find Full Text PDFFluconazole-Induced adrenal insufficiency following allogeneic hematopoietic cell transplant.
J Oncol Pharm Pract
December 2022
Blood and Marrow Transplant and Cellular Therapy Program, Abramson Cancer Center and the Division of Hematology and Oncology, 21798Hospital of the University of Pennsylvania, Philadelphia, PA.
Introduction: Adrenal insufficiency (AI) is a potentially life-threatening endocrine abnormality rarely associated with azole antifungals. Patients undergoing allogeneic hematopoietic cell transplantation (alloHCT) are at high risk of invasive fungal infection and frequently receive azoles. Signs and symptoms of AI, such as gastrointestinal symptoms, lethargy, and electrolyte disturbances frequently overlap with common alloHCT toxicities, such that azole-induced AI may be under-reported in this population.
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