Drug-induced thrombocytopenia in the coronary care unit.
Drug-induced thrombocytopenia is a phenomenon that causes significant morbidity and mortality among patients. Practitioners should be able to recognize the clinical manifestations of drug-induced thrombocytopenia, differentiate it from other causes, and manage it appropriately. Numerous case reports have documented drug-induced causes of thrombocytopenia. The following article focuses on the characteristics and management of drug-induced thrombocytopenia secondary to medications commonly encountered in the coronary care unit. Pharmacotherapeutic agents that are most commonly implicated in this setting include ticlopidine, unfractioned heparin, glycoprotein (GP)IIb/IIIa inhibitors, H(2)-receptor antagonists, quinidine and antibiotics. Case reports were obtained through a comprehensive search of the Medicine database and subsequently complemented by bibliographic reviews of the agents just specified. Reports that exhibited possible, probable, and definite associations with drug-induced thrombocytopenia are included in the article.
Patnode
N M
NM
University of Massachusetts Memorial Health Care, Worcester, Massachusetts, USA.
Gandhi
P J
PJ
D000925:Anticoagulants / Q000009:adverse effects; D003325:Coronary Care Units; D003937:Diagnosis, Differential; D005343:Fibrinolytic Agents / Q000009:adverse effects; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications / Q000209:etiology; D013988:Ticlopidine / Q000009:adverse effects
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D006493:Heparin; D013988:Ticlopidine