Learn vocabulary, terms, and more with flashcards, games, and other study tools. Druginduced megaloblastic, aplastic, and hemolytic anemias. The kidney maintains the vital functions of clearing excess body fluid and removing metabolic and exogenous toxins from the blood the kidney is particularly. Drug induced hematologic disorders ranked according to highest incidence of mortality aplastic anemia thrombocytopenia agranulocytosis hemolytic anemia t or f. Drugs can affect all types of blood cells and induce different disorders. For example, heavy alcohol consumption can cause generalized. Antipsychoticdrug induced hematologic sideeffects are not particularly highly prevalent, while many of them are found in case reports. Alcohol has numerous adverse effects on the various types of blood cells and their functions. A casehistory study of druginduced blood disorders pancytopenia, hemolytic anemia, thrombocytopenia, and granulocytopenia was carried out at the group. An epidemiologic study from europe and the united states showed an annual incidence of 10 cases per 1 mil lion persons, but numbers could be higher in older persons and in hospitalized patients. Pdf druginduced hematologic syndromes researchgate. Metabolic abnormalities and enzyme deficiency hemolyt ic anemias. The major hematologic manifestations of sle include anemia, leukopenia, thrombocytopenia, lymphadenopathy, andor splenomegaly. Diagnosing druginduced pulmonary disease remains a challenge for all pulmonologists.
Unfortunately, this book cant be printed from the openbook. Hematologic disorders amongst the most common disorders facing man today and they mainly include illnesses that interfere with the blood. Druginduced injury is a major cause of acute liver failure. Antipsychotic druginduced hematologic disorders core. List diagnostic criteria for identifying druginduced aplastic anemia, agranulocytosis, hemolytic anemia, megaloblastic anemia, and thrombocytopenia. Drug induced hemotologic disorders flashcards quizlet. View the article pdf and any associated supplements and figures for a period of 48 hours. The table summarizes the druginduced hematological syndromes discussed above. These hematologic dyscrasias may concern all the blood cell series as well as the coagulation mechanism.
Druginduced hematologic disorders are more common in the elderly than in the young. Druginduced immune hematologic disease sciencedirect. The evaluation of hematologic disorders after solid organ transplantation sot must take into account issues unique to the posttransplant setting that influence the development of anemia and single or multilineage cytopenias. The wide spectrum of druginduced hematologic syndromes is mediated by a variety of mechanisms, including immune effects, interactions with enzymatic pathways, and direct inhibition of hematopoiesis. Mortality and morbidity druginduced macrocytic anemia is usually relatively benign and generally does not result in significant morbidity and mortality. A hyperkinetic sensorimotor movement disorder characterized by restlessness and the irresistible urge to move.
Recognition and management of druginduced blood disorders. Except for heparininduced thrombocytopenia, there are no rapid tests available to establish quickly if the suspect drug is the cause of the hematologic disorder. Obsessivecompulsive disorder prevention of chemotherapyinduced nausea and vomiting phencyclidine psychosis improving. The food and drug administration granted accelerated approval to polatuzumab vedotinpiiq polivy, genentech, inc. When a drug causes decreases in all three cell lines accom panied by a hypoplastic bone marrow, the result is druginduced aplastic anemia. These illnesses are brought by drug use that tampers with the structure of the white blood cells, platelets, the white blood cells and the entire coagulation system. Oxidant hemolysis, including glucose6phosphate dehydrogenase g6pd deficiency. Drug induced hematological disorders flashcards quizlet. The most common druginduced hematologic disorders include aplastic anemia, agranulocytosis, megaloblastic anemia, hemolytic anemia, and. Some agents, such as hemolytics, cause predictable hematologic disease, but others induce idiosyncratic reactions not directly related to the drugs pharmacology. Caucasian women and the middleaged are at highest risk for hematologic side effects.
Although druginduced hematologic disorders are less common than other types of adverse reactions, they are associated with significant morbidity and mortality. Other than drugs, various other clinical conditions can cause druginduced hematological cytopenia. Hematologic side effects of psychotropics sciencedirect. In the past five years, two drugs have been withdrawn from the market by the food and drug administration fda for causing severe. This paper aims to emphasize the broad range of druginduced hematological syndromes and to highlight some of the newer drugs and syndromes. For this reason they have not drawn much of attention.
Some of these drug induced hematological syndromes have. However, alcohol related hematological problems can occur at much lower consumption levels. Druginduced hematologic disorders pocket icu management. Druginduced thrombocytopenia is the most common druginduced hematologic disorders, with some reports suggesting that as many as 5% of patients who receive heparin develop heparininduced thrombocytopenia. Article pdf available january 2017 with 873 reads how we measure reads. Since the initial description,2 fewer than 300 cases of avwd have been reported,3 and there are no accurate estimates of its prevalence. Some agents causes predictable hematologic disease e. Therefore it is important to take a detailed history and analyze sequence of event while looking for the cause of druginduced cytopenia. Druginduced hematologic problems are rare, but potentially lifethreatening, side effects of psychotropics.
Druginduced hematologic disorders is a topic covered in the pocket icu management to view the entire topic, please sign in or purchase a subscription anesthesia central is an allinone web and mobile solution for treating patients before, during, and after surgery. We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. Describe the clinical relevance and incidence of druginduced hematologic disorders. Ain caused by beta lactam and sulfa based antibiotics is usually begins 2 weeks after drug exposure but may occur sooner if patient has been previously sensitized to the same or a chemically similar agent. Prevention primary prevention of druginduced macrocytic anemia involves avoidance of agents known to cause the disorder. Disease severity is wide ranging, with most suffering milder. A free powerpoint ppt presentation displayed as a flash slide show on id. Pure red cell aplasia prca is an uncommon hematologic disorder characterized by the absence of erythroblasts in otherwise normal bone marrow. Medication induced blood dyscrasias etiology and disease. Druginduced hematological disorders can span almost the entire spectrum of hematology, affecting red cells, white cells, platelets, and the. The incidence of significant hematologic side effects is 1 to 2 casesyear per 100,000 subjects.
Druginduced folate deficiency the national academies. Pyruvate kinase deficiency and other metabolic deficiencies. Nonchemotherapy idiosyncratic druginduced neutropenia idin is a relatively rare but potentially fatal disorder that occurs in susceptible individuals, with an incidence of 2. This ppt is regarding drug induced hematological disorders, covering the definitions, causative drugs, pathophysiological mechanisms, manifestations,and management of 5 blood disorders. If you need to print pages from this book, we recommend downloading it as a pdf. Drugs can induce almost the entire spectrum of hematologic disorders, affecting white cells, red cells, platelets, and the. A casehistory study of druginduced blood disorders pancytopenia, hemolytic anemia, thrombocytopenia, and granulocytopenia was carried out at the group health cooperative of puget sound, a health maintenance organization with more than 200,000 members, for the tenyear period from 1972 through 1981. Druginduced thrombocytopenia is the most common druginduced hematologic disorder, with reports suggesting that between 0. Merck manual, professional edition, aplastic anemia. Ppt druginduced kidney disease powerpoint presentation. Druginduced hematologic disorders are generally rare adverse effects associated with drug therapy. Different classes of drugs, by virtue of immunological mechanisms or direct toxicity initiate certain stereotyped renal responses.
When attempting to determine if a drug caused a hematologic disorder it is acceptable to rechallenge a patient in order to prove that the drug caused the disorder. Drug induced immune mediated hemolytic anemia penicillin high dose methyldopa. Druginduced kidney diseases np singh, a ganguli, a prakash abstract druginduced kidney disease constitutes an important cause of acute renal failure and chronic kidney disease in present day clinical practice. The most common druginduced hematologic disorders include aplastic anemia, agranulocytosis, megaloblastic anemia, hemolytic anemia, and thrombocytopenia. Reporting during postmarketing surveillance of a drug is usually the method by which the incidence of rare adverse drug reactions is established. Patients with a history of a clinically significant low wbc or druginduced leukopenianeutropenia should have their complete blood count cbc monitored frequently during the first few months of therapy and discontinuation of abilify maintena should.
During pregnancy, preeclampsia and the hellp hemolysis, elevated liver enzymes, and low platelet count syndrome are associated with thrombocytopenia. Drugs can induce almost the entire spectrum of hematologic disorders, affecting white cells, red cells, platelets, and the coagulation system. Druginduced hematologic disorders can affect any cell line, including white. Hematologic disorders after solid organ transplantation. Unfortunately, because older patients are at risk for druginduced hematologic diseases 56 and polypharmacy, the cause is not often that clear.
1040 62 335 1474 241 242 1193 752 684 476 778 682 327 2 1271 767 348 1311 782 523 1460 1015 999 1490 334 162 976 233 1353 122 1368 926