Evaluation and management of drug-induced thrombocytopenia in the acutely ill patient

• Published in: Pharmacotherapy Vol. 20; no. 3; p. 292
• Main Authors: Wazny, L D, Ariano, R E
• Format: Journal Article
• Language: English
• Published: United States 01.03.2000
• Subjects: Acute Disease; Anticoagulants - therapeutic use; Antineoplastic Agents - therapeutic use; Chondroitin Sulfates - therapeutic use; Critical Care - methods; Dermatan Sulfate - therapeutic use; Disease Management; Drug Combinations; Fibrinolytic Agents; Heparitin Sulfate - therapeutic use; Hirudin Therapy; Hirudins - analogs & derivatives; Humans; Interleukin-11 - therapeutic use; Recombinant Proteins - therapeutic use; Thrombocytopenia - chemically induced; Thrombocytopenia - prevention & control; Thrombopoietin - therapeutic use
• ISSN: 0277-0008; 1875-9114
• DOI: 10.1592/phco.20.4.292.34883

The numerous drugs to which the acutely ill are exposed place these patients at a significant risk of developing drug-induced thrombocytopenia. Such patients tend to have preexisting hemostatic defects that place them at additional risk of complications as a result of the drug-induced thrombocytopenia. The clinical challenge is to provide rapid identification and removal of the offending agent before clinically significant bleeding or, in the case of heparin, thrombosis results. Drug-induced thrombocytopenic disorders can be classified into three mechanisms: bone marrow suppression, immune-mediated destruction, and platelet aggregation. Clinical characteristics, preliminary laboratory findings, and drug history specific to the mechanisms can assist clinicians in rapidly isolating the causative drug.