Depression, bone marrow

As regards toxicity, pyrazole itself induced hyperplasia of the thyroid, hepatomegaly, atrophy of the testis, anemia and bone marrow depression in rats and mice (72E1198). The 4-methyl derivative is well tolerated and may be more useful than pyrazole for pharmacological and metabolic studies of inhibition of ethanol metabolism. It has been shown (79MI40404) that administration of pyrazole or ethanol to rats had only moderate effects on the liver, but combined treatment resulted in severe hepatotoxic effects with liver necrosis. The fact that pyrazole strongly intensified the toxic effects of ethanol is due to inhibition of the enzymes involved in alcohol oxidation (Section 4.04.4.1.1). 

Many valuable compounds are aromatic in part, including steroids such as estrone and well-known pharmaceuticals such as the cholesterol-lowering drug alorvastatin, marketed as Lipitor. Benzene itself has been found to cause bone marrow depression and a consequent lowered white blood ceil count on prolonged exposure. Benzene should therefore be handled cautiously if used as a laboratory solvent. 

Due to the rapid appearance of resistance, 5FC is only used as a combination partner for the intensive therapy of established severe fungal infections caused by Candida spp., Cryptococcus neoformans and Aspergillus sp. Anorexia, nausea, vomiting, diarrhoea and or abdominal pain occur in 6% of the patients. Of greater concern is the potential for bone marrow depression (seen in 5% of the patients, all with elevated 5FC levels). 

Camptothecins (irinotecan, topotecan) are derived from the bark of the Chinese tree Xi Shu (Camptotheca accuminata). They inhibit topoisomerase I thus effecting double strand breaks. Unwanted effects include diarrhea and reversible bone marrow depression. 

Other adverse reactions associated with penicillin are hematopoietic changes such as anemia, thrombocytopenia (low platelet count), leukopenia (low white blood cell count), and bone marrow depression. When penicillin is given orally, glossitis (inflammation of the tongue), stomatitis (inflammation of die mouth), dry mouth, gastritis, nausea, vomiting, and abdominal pain occur. When penicillin is given intramuscularly (IM), there may be pain at die injection site Irritation of the vein and phlebitis (inflammation of a vein) may occur witii intravenous (IV) administration. 

The drug is contraindicated in die presence of an allergy to die drug, pregnancy (Category C), lactation, and phenylketonuria (oral form only). Linezolid is used cautiously in patients with bone marrow depression, hepatic dysfunction, renal impairment, hypertension, and hyperthyroidism. 

An additive nephrotoxicity develops when pentamidine isethionate is administered with other nephrotoxic drugs (eg, aminoglycosides, vancomycin, or amphotericin B). An additive bone marrow depression occurs when the drug is administered with antineoplastic drugs or when the patient lias received radiation therapy recently. 

It is important to monitor closely serum blood levels of chloramphenicol, particularly in patients with impaired liver or kidney function or when administering chloramphenicol with other drugs metabolized by the liver. Blood concentration levels exceeding 25 mcg/mL increase the risk of the patient developing bone marrow depression. 

Flucytosine is contraindicated in patients with known hypersensitivity to the drug. Flucytosine is used cautiously in patients with bone marrow depression and with extreme caution in those with renal impairment. The drug is also used cautiously during pregnancy (Category C) and lactation. When flucytosine and amphotericin B are administered concurrently, the risk of flucytosine toxicity is increased. 

Chloroquine is contraindicated in patients with known hypersensitivity. It is a good idea to use chloroquine cautiously in patients with hepatic disease or bone marrow depression and during pregnancy. Children are very sensitive to chloroquine, and the drug should be used with extreme caution in children. 

Nausea, vomiting, diarrhea, abdominal pain, bone marrow depression... 

The adverse reactions seen with penicillamine include pruritus, rash, anorexia, nausea, vomiting, epigastric pain, bone marrow depression, proteinuria, hematuria, increased skin friability, and tinnitus. Penicillamine is capable of causing severe toxic reactions. 

There is an increased risk of toxicity of MTX when administered with the NSAIDs, salicylates, oral antidiabetic drugs, phenytoin, tetracycline, and probenecid. There is an additive bone marrow depressant effect when administered with other drug known to depress the bone marrow or with radiation therapy. There is an increased risk for nephrotoxicity when MTX is administered with other drug that cause nephrotoxicity. When penicillamine is administered with digoxin, decreased blood levels of digoxin may occur. There is a decreased absorption of penicillamine when the dmg is administered with food, iron preparations, and antacids. 

The miscellaneous anticonvulsants are contraindicated in patients with known hypersensitivity to any of the dru. Carbamazepine is contraindicated in patients with bone marrow depression or hepatic or renal impairment and during pregnancy (Category D). Valproic acid is not administered to patients with renal impairment or during pregnancy (Category D). Oxcarbazepine (Trileptal), a miscellaneous anticonvulsant, may exacerbate dementia... 

BENZODIAZEPINES Carbamazepine may cause aplastic anemia and agranulocytosis. During treatment blood studies are performed frequently If evidence of bone marrow depression is obtained (eg, the patient s platelet... 

The antipsychotics are contraindicated in patients with known hypersensitivity to the drug s, in comatose patients, and in those who are severely depressed, have bone marrow depression, blood dysera ias, Parkinson s disease (haloperidol), liver impairment, coronary artery disease, or severe hypotension or hypertension. 

Bone marrow depression, anemia, blood dyscrasias, nausea, vomiting, tachycardia, itching, rash, hives, tenderness and swelling of the neck, sore throat, and cough... 

Reactions after administration of 131I include sore diroat, swelling in the neck, nausea, vomiting, cough, and pain on swallowing. Otiier reactions include bone marrow depression, anemia, leukopenia, thrombocytopenia, and tachycardia... 

There is an additive bone marrow depression when methimazole or propylthiouracil is administered with otiier bone marrow depressants, such as the antineo-plastic drugs, or witii radiation therapy. When methimazole is administered with digitalis, there is an increased effectiveness of the digitalis and increased risk of toxicity. There is an additive effect of propylthiouracil when the drug is administered with lithium, potassium iodide, or sodium iodide When iodine products are administered with litiiium products, synergistic hypotiiyroid activity is likely to occur. 

Anemia, proteinuria, nausea, vomiting, fever, rash, leukopenia, neutropenia, thrombocytopenia, diarrhea, constipation, alopecia Bone marrow depression, hyperuricemia, hepatotoxicity, skin rash... 

Ulcerative stomatitis, nausea, rash, pruritus, renal failure, bone marrow depression, fatigue, fever, chills... 

Bone marrow depression, anemia, nausea, vomiting, diarrhea, rash, fever... 

Nausea, diarrhea, stomatitis, hypotension, anorexia, bone marrow depression, pulmonary congestion, dyspnea, oliguria Dysuria, urinary frequency, cystitis, hematuria, urinary incontinence... 

---