Episode 63: Chemo Prophylaxis with Andrew Jarrell

This podcast addresses the prophylaxis of venous thromboembolism (VTE) and stress ulcers in hospitalized patients. Andrew Jarrell, a SICU pharmacist at Johns Hopkins, explains that VTE can affect 10-30% of patients without prophylaxis, with the risk varying based on surgery type and patient population. Guidelines emphasize balancing VTE risk against bleeding risk, considering factors like ambulation, compression stockings, and IVC filters. The discussion covers pharmacologic options such as unfractionated heparin, low molecular weight heparin, fondaparinux, and aspirin, including dosing considerations for different patient weights and renal function. The podcast further explores stress ulcers, a type of hemorrhagic gastritis, and the use of proton pump inhibitors (PPIs) and histamine 2 receptor antagonists (H2RAs) for prophylaxis, while also weighing potential downsides like pneumonia and C. difficile infection.