Druginduced anemias are po tentially dangerous and have. Druginduced megaloblastic, aplastic, and hemolytic anemias. Although druginduced taste disorders can negatively affect disease treatment and quality of life, they are often overlooked by the medical community. Drugs induced blood disorders anemia neutropenia aplastic anemia hemolytic anemia macrocytic anemia 28. The term neurologic side effect is commonly used to describe a new druginduced neurologic syndrome andor disorder. While the exact cause of lupus is unknown, there is significant evidence that some medications may cause lupus in some cases. In addition, pharmacists can educate patients on ways to reduce the risk of druginduced bleeding and help them recognize the symptoms of druginduced bleeding.
This paper aims to emphasize the broad range of druginduced hematological syndromes and to highlight some of the newer drugs and syndromes. Hematological disorders arise through a variety of mecha nisms and etiologies. These tend to be relatively common, are always serious, and frequently can be lifethreatening. Druginduced hematological disorders can span almost the entire spectrum of hematology, affecting red cells, white cells, platelets, and the. Other risk factors include a family history of parkinsons and affective disorders. Acute posthemorrhagic anemia anemia in neoplastic disease anemia in chronic kidney disease anemia in other chronic disease. There may be a genetic predisposition to druginduced parkinsonism.
For example, heavy alcohol consumption can cause generalized suppression of blood cell production and the production of structurally abnormal. One price of the therapeutic revolution is the everincreasing number of adverse drug reactions. This activity is intended for physicians, psychiatrists, pharmacists, and other clinicians who prescribe medications that can cause druginduced movement disorders or who treat patients who have such disorders. Drugs can affect all types of blood cells and induce different disorders. Druginduced endocrine and metabolic disorders springerlink. The four major blood dyscrasias attributable to drugs are. Recognition and management of druginduced blood disorders. Moreover, the causal relationship of a particular anticancer drug with cardiac arrhythmia occurrence remains challenging due in part to patient comorbidities and complex treatment regimens.
Druginduced hepatitis is a redness and swelling inflammation of the liver that is caused by a harmful toxic amount of certain medicines. Some of the effects of the drugs are predictable while others remain unpredictable. The most common druginduced hematologic disorders include aplastic anemia, agranulocytosis, megaloblastic anemia, hemolytic anemia, and thrombocytopenia. Drugs can induce almost the entire spectrum of hematologic disorders, affecting white cells, red cells, platelets, and the coagulation system. Few epidemiologic studies have evaluated the actual incidence. Agranulocytosis or leukopenia loss of the white blood cells aplastic anemia loss of all the formed elements of the blood thrombocytopenia loss of the platelets hemolytic. Drugs considered lupus inducing vary in pharmacologic. Druginduced renal disease, like other iatrogenic disorders, bedevils the patient and humbles the physician when he finds that he has done harm at the time he thought he was doing good. The liver helps to break down certain medicines in your blood. Describe the clinical relevance and incidence of druginduced hematologic disorders.
Start studying therapy drug induced hematologic disorders. Druginduced blood disorders have also been the reason for withdrawal for a number of drugs, notably remoxipride in 1994. The hematological complications of alcoholism harold s. Glutathione participates in the hepatic detoxification of many compounds via glutathione stranferase. Acquired hemolytic anemia an overview sciencedirect topics.
The incidence of druginduced parkinsonism increases with age. A casehistory study of druginduced blood disorders pancytopenia, hemolytic anemia, thrombocytopenia, and granulocytopenia was carried out at the group. 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. The first page of the pdf of this article appears above. This ppt is regarding drug induced hematological disorders, covering the definitions, causative drugs, pathophysiological mechanisms, manifestations,and management of 5 blood disorders. This drug induced hematological disorders span the whole range of body hematology affecting red blood cells, platelets, coagulation system, and the white blood cells. Drug induced hematological disorders arise from a vast array of mechanism and etiologies. Druginduced hematological disorders can span almost the entire spectrum of hematology, affectin gred cells, white cells, platelets, and the coagulation system 1. Get a printable copy pdf file of the complete article 152k, or click on a page image below to browse page by page. Druginduced bleeding disorders can be categorized according to the manner in which they embarrass hemostasis. Usually, druginduced hypertension is of a transient nature, and a careful evaluation of the individuals drug regimen may help identify the drug causing high blood pressure the common signs and symptoms of druginduced hypertension include headache, lightheadedness, nausea, vomiting, muscle tremors, and excessive sweating. Therapy drug induced hematologic disorders flashcards. Druginduced hematological disorders can span almost the entire spectr um of hematology, a. The mechanisms of druginduced liver disease are diverse, representing many phases of biotransformation, and are susceptible to genetic polymorphism.
An acquired hemolytic anemia can develop in association with drugs. 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. Drug induced blood disorders free download as word doc. Renal disease induced by drugs was studied by percutaneous biopsy in 40 patients. Little concerns seem to be given to taste disorders that might be induced by the drug candidates of interest. Thank you for your interest in spreading the word about the bmj. Drug induced hematology lecturer nin prapongsena huachiew chalermprakiet university 2. Anticoagulants are medicines used to prevent the formation of bood clots. Alcohol has numerous adverse effects on the various types of blood cells and their functions.
Claims data uniquely provides patterns that are consistent with trends in druginduced disease, allowing for the identification of druginduced disease even in the absence of traditional clinical data such as vital signs and lab values. In druginduced thyroiditis, thyroid gland becomes underactive mainly because of different reactions from certain medications which usually alter the binding of thyroid hormone to globulin protein or the thyroid hormone metabolism and absorption. Druginduced blood disorders europe pmc article europe. Blood disorders, many of which carry an attendant high morbidity or mortality, constitute a significant part of druginduced problems. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Found in patients with g6pd, glutathione peroxidase deficiencies g6pd deficiency is a disorder of hmp shunt g6pd deficiency causes lack of nadph concentration in rbcs reduces glutathione levels in reduced form no substrate available for glutathione peroxidase to bind on reduces protective effect of glutathione peroxidase on rbcs peroxides attack rbcs oxidative stress leads to hemolysis with reduced glutathione levels oxidizing drugs oxidize. Druginduced hematologic disorders pocket icu management. When a drug causes decreases in all three cell lines accompanied by a hypoplastic bone marrow, the result is druginduced aplastic anemia. 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. On completion of this chapter, the student will be able to.
Pharmacists may not routinely anticipate or recognize these new conditions. A fulminant or severe druginduced reaction within the liver usually involves the immune system and is marked by largescale cell necrosis. Get a printable copy pdf file of the complete article 261k, or click on a page image below to browse page by page. Pdf druginduced hematologic syndromes researchgate. Anticancer druginduced kidney disorders springerlink. Druginduced parkinsonism is more prevalent in older people and is twice as common in women than men. Drug induced anaemia and other blood disorders are potentially. This rare adverse effect occurs in approximately 15,000 to 30,000 individuals per year in the united states. 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. The goal of this activity is to educate clinicians on druginduced movement disorders and the drugs that cause them. Full text full text is available as a scanned copy of the original print version. In investigating the possibility of a druginduced hemolytic anemia, one must consider not only the prescription medications that the patient is taking, but also overthecounter medications and even possible chemical exposures. Drug induced hematological disorders barbra doziers blog. Drugs can induce almost the entire spectrum of hematologic disorders, affecting white cells, red cells, platelets, and the.
Druginduced neutropenia can occur in association with various analgesics, psychotropics. Doserelated nephrotoxicity subsequent to administration of certain chloroethylnitrosourea compounds carmustine, semustine and streptozocin is commonly heralded by increased serum creatinine levels, uraemia and. Know the causes, symptoms, treatment, complications and prognosis of druginduced thyroiditis. List diagnostic criteria for identifying druginduced aplastic anemia, agranulocytosis, hemolytic anemia, megaloblastic anemia, and. The most common druginduced hematologic disorders include aplastic anemia, agranulocytosis, megaloblastic anemia, hemolytic anemia, and.
Hypoprothrombinemia, anticoagulant induced refers to a condition where there is a deficiency of prothrombin in the blood which causes impaired clotting and increased risk of bleeding caused by excessive use of an anticoagulant. List of hypoprothrombinemia, anticoagulant induced. Druginduced hematologic disorders are generally rare adverse effects associated with drug therapy. Long history of abnormal platelet count or family history of thrombocytopenia many disorders. Anticancer druginduced cardiac rhythm disorders remain an underappreciated complication even by experienced clinicians. Druginduced hematologic disorders can affect any cell line, including white blood cells wbcs, red blood cells rbcs, and platelets. What is druginduced thyroiditiscausessymptomstreatment. Druginduced blood disorders journal of clinical pathology. Large doses of benzylpenicillin penicillin g may promote urinary potassium excretion by acting as nonreabsorbable anions in the distal renal tubule. Druginduced diseases are primarily diagnosed based on the history of drug intake obtained from the patient or the family. Druginduced bleeding is commonly thought of as gastrointestinal gi bleeding resulting from the use of nonsteroidal antiinflammatory drugs nsaids.
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