Evaluation and management of drug-induced thrombocytopenia in the acutely ill patient.
The numerous drugs to which the acutely ill are exposed place these patients at a significant risk of developing drug-induced thrombocytopenia. Such patients tend to have preexisting hemostatic defects that place them at additional risk of complications as a result of the drug-induced thrombocytopenia. The clinical challenge is to provide rapid identification and removal of the offending agent before clinically significant bleeding or, in the case of heparin, thrombosis results. Drug-induced thrombocytopenic disorders can be classified into three mechanisms: bone marrow suppression, immune-mediated destruction, and platelet aggregation. Clinical characteristics, preliminary laboratory findings, and drug history specific to the mechanisms can assist clinicians in rapidly isolating the causative drug.
Wazny
L D
LD
Department of Pharmacy, St. Boniface General Hospital, University of Manitoba, Winnipeg, Canada.
Ariano
R E
RE
D000208:Acute Disease; D000925:Anticoagulants / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002809:Chondroitin Sulfates / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods; D003871:Dermatan Sulfate / Q000627:therapeutic use; D019468:Disease Management; D004338:Drug Combinations; D005343:Fibrinolytic Agents; D006497:Heparan Sulfate / Q000627:therapeutic use; D024764:Hirudin Therapy; D006629:Hirudins / Q000031:analogs & derivatives; D006801:Humans; D017370:Interleukin-11 / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000517:prevention & control*; D013926:Thrombopoietin / Q000627:therapeutic use
D000925:Anticoagulants; D000970:Antineoplastic Agents; D002809:Chondroitin Sulfates; D003871:Dermatan Sulfate; D004338:Drug Combinations; D005343:Fibrinolytic Agents; D006497:Heparan Sulfate; D006629:Hirudins; D017370:Interleukin-11; D011994:Recombinant Proteins; D013926:Thrombopoietin; C035838:danaparoid; C105308:oprelvekin; C083544:lepirudin