Thrombocytopenia drugs causing

Adverse effects in general are discussed below. Rashes (sometimes photosensitive), thrombocytopenia and agranulocytosis occur. Treatment with thiazide-type drugs causes an increase in total serum cholesterol, but on long-term usage even of high doses this is less than 5%. The questions about the appropriateness of use of these drugs for mild hypertension, of which ischaemic heart disease is a common complication, have been laid to rest by their proven success rates in randomised outcome comparisons. 

UNTOWARD EFFECTS Rifabutin generally is well tolerated in persons with HIV infection primary reasons for discontinuation of therapy include rash (4%), GI intolerance (3%), and neutropenia (2%). Overall, neutropenia occurred in 25% of patients with severe HIV infection who received rifabutin. Uveitis and arthralgias have occurred in patients receiving rifabutin doses >450 mg daily in combination with clarithromycin or fluconazole. Patients should be cautioned to discontinue the drug if visual symptoms occur. Like rifampin, the drug causes an orange-tan discoloration. Rarely, thrombocytopenia, a flu-like syndrome, hemolysis, myositis, chest pain, and hepatitis have occurred. 

Hematologic A 30-year-old man took oral ciprofloxacin 1 g/day for 3 days for a suspected urinary tract infection and developed a rapidly fatal hemolytic anemia and severe thrombocytopenia [38 ]. The authors attributed the hemolysis and thrombocytopenia to ciprofloxacin, but a non-drug cause could not be ruled, since hematuria preceded exposure to ciprofloxacin. 

Mebendazole—The patient may chew, swallow whole, or mix the tablets with food. The patient should take these drugs with foods high in fat to increase absorption. The nurse should make sure a complete blood count is obtained before therapy and periodically during therapy because mebendazole can cause leukopenia or thrombocytopenia. 

WARNING Renal impair is the major tox foUow administration instructions Uses CMV retinitis w/ HIV Action Selective inhibition of viral DNA synth Dose Rx 5 mg/kg IV over 1 h once/wk for 2 wk w/ probenecid Maint 5 mg/kg IV once/2 wk w/ probenecid (2 g PO 3 h prior to cidofovir, then 1 g PO at 2 h 8 h after cidofovir) X in renal impair Caution [C, -] Contra Probenecid or sulfa allergy Disp Inj SE Renal tox, chills, fever, HA, NA /D, thrombocytopenia, neutropenia Interactions t Nephrotox W/ aminoglycosides, amphot icin B, foscar-net, IV pentamidine, NSAIDs, vancomycin t effects W/zidovudine EMS Monitor ECG for hypocalcemia (t QT int val) and hypokalemia (flattened T waves) OD May cause renal failure hydration may be effective in reducing drug levels/effects Cilostazol (Pletal) TAntiplatelet, Arterial Vasodilator/ Phosphodiesterase Inhibitor] Uses Reduce Sxs of intermittent claudication Action Phosphodiesterase in inhibitor t s cAMP in pits blood vessels, vasodilation inhibit pit aggregation Dose 100 mg PO bid, 1/2 h before or 2 h after breakfast dinner Caution [C, +/-] Contra CHE, hemostatic disorders. 

C. Reteplase binds to fibrin to cause a selective activation of fibrin-bound plasminogen. All fibrinolytic drugs are administered IV. Streptokinase is antigenic, whereas reteplase is not. Thrombocytopenia is not normally caused by thrombolytic drugs. 

Normochromic normocytic anemia is the most common hematological side effect of amphotericin B administration thrombocytopenia and leukopenia are much less common. Infusion of the drug into a peripheral vein usually causes phlebitis or thrombophlebitis. Nausea, vomiting, and anorexia are a persistent problem for some patients. 

The major toxicity associated with mitomycin therapy is unpredictably long and cumulative myelosup-pression that affects both white blood cells and platelets. A syndrome of microangiopathic hemolytic anemia, thrombocytopenia, and renal failure also has been described. Renal, hepatic, and pulmonary toxicity may occur. The drug is teratogenic and carcinogenic, and it can cause local bhstering. 

Rapamycin, also known as sirolimus, is a new macrolide antibiotic that interacts with cellcycle regulating proteins and inhibits cell division. The main side effects are thrombocytopenia and hyperlipidaemia. There is also evidence that it causes interstitial pneumonitis, which may resolve on withdrawing the drug or dose reduction. The drug is currently being assessed for combination therapy with tacrolimus or cyclosporin. 

The toxicity of inamrinone includes nausea and vomiting arrhythmias, thrombocytopenia, and liver enzyme changes have also been reported in a significant number of patients. This drug has been withdrawn in some countries. Milrinone appears less likely to cause bone marrow and liver toxicity than inamrinone, but it does cause arrhythmias. Inamrinone and milrinone are now used only intravenously and only for acute heart failure or severe exacerbation of chronic heart failure. 

Among the more severe adverse reactions, Stevens-Johnson epidermal necrolysis syndrome, thrombocytopenia, agranulocytosis, and nephrotic syndrome have all been observed. Like diclofenac, sulindac may have some propensity to cause elevation of serum aminotransferases it is also sometimes associated with cholestatic liver damage, which disappears when the drug is stopped. 

Uses Serious Infxns d/t susceptible bacteria Action Bactericidal X- cell wall synth Dose Adults. 250-1000 mg (imipenem) IV q6-8h, 500-750 mg IM 1/2 h Peds. 60-100 mg/kg/24 h IV - q6h X- if CrCl is <70 mL/min Caution [C, +/-] Probenecid T tox Contra Ped pts w/ CNS Infxn (T Sz risk) <30 kg w/ renal impair Disp Inj SE Szs if drug accumulates, GI upset, thrombocytopenia Interactions T Risks of Szs W/ cyclosporine, ganciclovir T effects W/ probenecid EMS Monitor for S/Sxs of super Infxn T Sz risk w/ high doses monitor for signs of electrolyte disturbances and hypovolemia d/t D OD May cause N/V/D symptomatic and supportive... 

Yamada T, Shinohara K, Katsuki K. Severe thrombocytopenia caused by simvastatin in which thrombocyte recovery was initiated after severe bacterial infection. Clin Drug Invest 1998 16 172-4. 

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