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    Volume 2, Issue 1
    Case Report
    Hoffman Zachary, Lewis Nathan, and Chuidian Francis X*
    Cerebral venous sinus thrombosis (CVST) is a rare stroke-like syndrome with significant morbidity and mortality. It primarily affects the young, healthy patient. Recognition of risk factors, symptoms and its treatment can provide full recovery from neurological sequela. We present a case of a young post-partum patient that presented to our Emergency Department with headaches that were thought to be a complication of a post epidural procedure she received during labor and her treatment with epidural blood patches.
    Jenny New, Kathie Le, Kimberly A. Wong, Shelley J. Choi, Charles L. Danh, Joseph D. Hall, and Elena Kret-Sudjian
    Adverse effects from prescription drugs remain a major cause of morbidity and death in the US. Ticagrelor is a P2Y12 receptor antagonist approved for the reduction of stent thrombosis in patients with acute coronary syndrome (ACS). Current American Heart Association/American College of Cardiology (AHA/ACC) treatment guidelines for ACS recommend antiplatelet therapy, high-intensity statins, and angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB) especially for patients with hypertension or chronic kidney disease (CKD). In the Platelet Inhibition and Patient Outcomes (PLATO) trial, ticagrelor was associated with fewer deaths from vascular causes, myocardial infarction, and stroke in patients with CKD. However, it also was associated with significant increases in serum creatinine compared to the clopidogrel group.There are no anticipated pharmacokinetic interactions between ticagrelor, statins, and ACEI/ARBs, and there have been few reported cases of rhabdomyolysis associated with the use of statins in combination with ticagrelor. Herein, we report a case of acute renal failure and rhabdomyolysis associated with the concomitant use of ticagrelor, rosuvastatin, and losartan. Clinicians should be aware of this potential interaction in patients with both ACS and CKD.
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