Thrombocytopenia drugs involved

Non-dose-related or idiosyncratic adverse effects of ethosuximide are extremely uncommon. Skin rashes have been reported, including at least one case of Stevens-Johnson syndrome. A few patients have had eosinophilia, thrombocytopenia, leukopenia, or pancytopenia it is not entirely certain that ethosuximide was the causal agent. The development of systemic lupus erythematosus has also been reported, but other drugs may have been involved. 

Thrombocytopenia is a relatively common feature in both acute and chronic liver disease and is proportional to the extent of liver disease. The etiology of thrombocytopenia in liver disease is multifactorial, but involves primarily hypersplenism with pooling of platelets, immune-mediated destruction, and the inability of the bone marrow to compensate for the accelerated removal. The bone marrow depression may be related to alcohol, drugs, and nutritional deficiencies associated with the cirrhotic process. ... 

Inadequate blood clotting may result from vitamin K deficiency, genetically determined errors of clotting factor synthesis (eg, hemophilia), a variety of drug-induced conditions, and thrombocytopenia. Treatment, therefore, involves administration of vitamin K, preformed clotting factors, or an-tiplasmin drugs. Thromhocytopenia may be treated by administration of platelets. 

Table 8. Drugs frequently involved in thrombocytopenia. (Adapted from van Arsdel 1978 Parker 1980)...

Molecules that damage or affect normal bone marrow functions may induce immunotoxicity as well, since bone marrow is the site of hematopoiesis. Clinical manifestations of drug-induced myelotoxicity include peripheral pancytopenia if stan cells or all hematopoietic lineages are involved or anemia, leukopenia, and/or thrombocytopenia, if only specific lineages are affected (Carey, 2(X)3 Evans, 2008). Typical bone marrow culture assays focus on granulocyte, monocyte, megakaryocyte, and/ or erythroid lineages. Lymphopoiesis can be evaluated by other functional assays such as lymphocyte proliferation assays, which may include assessment of proliferation of individual lymphoid subsets. For more details on assessment of bone marrow toxicity, please see ChapterIV.il. 

As well as erythrocytes, other cells including platelets (thrombocytes) and some hanatopoietic precursor cells can be affected by drag-induced type II hypersensitivity reactions. Drag-induced thrombocytopenia for example is increasing as more drags are released and used. A number of different mechanisms appear to be involved. Drugs may bind covalently to the platelet mem-... 

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... 

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