Hematologic Drugs

The most prescribed drugs for blood-related disorders are also summarized in Table 1.17. Blood clots can occur in the veins at extremities (especially after a long period of immobility). Those clots can subsequently become lodged in the blood vessels, the atria, the heart valves, and within the lungs, causing embolism and shortness of breath. Under severe conditions, the clots can also obstruct the flow of blood to the brain, leading to a stroke and paralysis. Coumadin (warfarin see chemical structure below) is one of the main hematological compounds that has been widely prescribed to counter these conditions 

Twenty to 24 million prescriptions of Coumadin were dispensed in the United States during 2003-2005. Coumadin is an anticoagulant that acts by preventing the synthesis of active vitamin K, a necessary cofactor for synthesizing active clotting factors. Thus, preventing the synthesis of active vitamin K indirectly inhibits the formation of active clotting factors, notably factor II (prothrombin), VII, IX, and X in the liver. Ironically, coumarins, of which Coumadin is a member, are also used as rodenticides. 

Similarly, iron is an essential mineral in hemoglobin that is required to transport oxygen. It is also an essential nutrient in bone marrow, liver, and spleen. Iron deficiency, for example, in cases of anemia, is therefore routinely supplemented with ferrous sulfate or a variety of other iron-based compounds. If its supplementation is not urgent, it can also be replenished by adapting iron-rich diets. Prescribed iron supplements feature in the top 200 most prescribed dmgs in the United States only in 2004 (Table 1.17). 

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Lung Cancer Malignant Sarcoma Supportive Hematology Drug Costs... 

After 6, 12, 18 months and terminally Hematology Drug-related haematological deviations... 

Hematologic Drug-induced immune thrombocytopenia can occur after exposure to many medications and is sometimes indistinguishable from idiopathic thrombocytopenic purpura. When it is suspected. 

Hematologic Drug-induced agranulocytosis is the most serious disorder associated with thionamide therapy it can be life threatening, with a reported mortality of 5-15%. 

Nitrogen mustard is clinically used for the treatment of lymphomas and some forms of lung cancer. The major indication for mechlorethamine is Hodgkin s disease as a part of the MOPP regimen (mechlorethamine + vincristine (oncovin) + procarbazine + prednisone). The usual dose consists of 6 mg/m2 on days 1 and 8. This drug has pronounced hematological toxicity (myelo-suppression). 

Rare cases of hemolytic anemia, including fatalities, have been reported with the administration of the cephalosporins. The patient should be monitored for anemia If a patient experiences anemia within 2 to 3 weeks after the start of cephalosporin therapy, drug-induced anemia should be considered. If hemolytic anemia is suspected, the primary health care provider will discontinue the drug therapy. The patient may require blood transfusions to correct tire anemia. Frequent hematological studies may be required. 

Hydroxychloroquine administration may result in irritability, nervousness, anorexia, nausea, vomiting, and diarrhea This drug also may have adverse effects on the eye, including blurred vision, comeal edema, halos around lights, and retinal damage. Hematologic effects, such as aplastic anemia and leukopenia, may also be seen. 

UNIT VII Drugs That Affect the Hematological System... 

Unit VII consists of two chapters dealing with dragp that affect the hematological system anticoagulants and tlirombolytic drug s, and agents used in the treatment of anemia... 

Carbamazepine Manufacturer recommends CBC and platelets (and possibly reticulocyte counts and serum iron) at baseline, and that subsequent monitoring be individualized by the clinician (e.g., CBC, platelet counts, and liver function tests every 2 weeks during the first 2 months of treatment, then every 3 months if normal). Monitor more closely if patient exhibits hematologic or hepatic abnormalities or if the patient is receiving a myelotoxic drug discontinue if platelets are less than 100,000/mm3, if white blood cell (WBC) count is less than 3,000/mm3 or if there is evidence of bone marrow suppression or liver dysfunction. Serum electrolyte levels should be monitored in the elderly or those at risk for hyponatremia. Carbamazepine interferes with some pregnancy tests. 

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