Hemolytic anemia drugs involved

L-Dopa produces some of the same manifestations that a-methyldopa produces, including sensitization of red cells by antibody (with or without hemolytic anemia), drug fever, rash, and leukopenia, but all of these manifestations are rare. The hemolytic anemia produced by L-dopa is very rare. It appears to be of the autoimmune type, involving Rh determinants analogous to the much more common hemolytic anemia seen with a-methyldopa therapy (Worlledge 1973). L-Dopa has also been reported to produce an acute non-hemolytic anemia (Alkalay and Zi-POLi 1977). 

Examples of type II cytotoxic antibody-mediated drug reactions include drug-induced immune hemolytic anemia, drug-induced thrombocytopenia where a number of different mechanisms are involved and acute agranulocytosis in which more than 70 % of cases are caused by drugs... 

In contrast to a-methyldopa-induced hemolytic anemia, most drug-induced hemolytic anemia, especially for penicillins [34] and cephalosporins [35], involves drug-dependent antibodies, presumably because the drug acts as a hapten to directly modify erythrocytes or form immune complexes [36], However, there are many examples where a drug, such as nomifensine, induces both drug- (or metabolite)-dependent and drug-... 

Dapsone in combination with trimethoprim is also used for the treatment of mild to moderate first episodes of TCP, or alone for PCP prophylaxis [115, 198]. The most frequent adverse events are dose related metheglobinemia and hemolytic anemia. Since multi-drug therapy began to be used in leprosy patients, an increasing number of a rare, idiosyncratic reaction with multiorgan involvement... 

In one clinical situation, the nature of the autologous carrier may be rather clearly defined this is in drug-induced hemolytic anemia based on immunologic mechanisms. It has been shown that destruction of erythrocytes is due to interaction of IgG antibodies with the red cell membrane after its appreciable penicilloy-lation during therapy with high doeses of penicillin (Levine and Redmond 1967). The antibodies involved were penicilloyl specific but it appeared possible that modified structures of the red cell surface are also contributing to the specificity. If this can be substantiated, the erythrocyte will be definitively implicated as the actual immunogenic carrier. 

Table 6. Drugs frequently involved in hemolytic anemia. (Adapted from van Arsdel 1978 Parker 1980)...

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