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  • Drug Induced Platelet Dysfunction

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Drug Induced Platelet Dysfunction

Aka: Drug Induced Platelet Dysfunction, Drug Induced Platelet Destruction, Drug induced Thrombocytopenia
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  1. See Also
    1. Platelet Bleeding Disorders
    2. Thrombocytopenia
    3. Thrombocytopenia Causes
  2. Causes: Thrombocytopenia
    1. Chemotherapeutic agents
      1. Alkylating Agents
      2. Antimetabolites
      3. Interferon
    2. Antibiotics
      1. Sulfonamides (e.g. Bactrim)
      2. Penicillins
      3. Cephalosporins
      4. Rifampin
      5. Vancomycin
    3. Cardiovascular Agents
      1. Abciximab (ReoPro)
      2. Eptifibatide (Integrilin)
      3. Digoxin
      4. Methyldopa
      5. Procainamide
      6. Quinidine
      7. Quinine
      8. Thiazide Diuretics (Hydrochlorothiazide, Chlorthalidone)
    4. H2 Antagonists
      1. Cimetidine (Tagamet)
      2. Ranitidine (Zantac)
    5. Neuropsychiatric agents
      1. Barbiturates
      2. Phenytoin (Dilantin)
      3. Valproic Acid (Depakene)
      4. Carbamazepine (Tegretol)
    6. Miscellanous Agents
      1. Alcohol Abuse
      2. Estrogens
      3. Gold Salts
      4. MMR Vaccine
      5. Sulfasalazine (Azulfidine)
      6. Heparin Induced Thrombocytopenia
        1. Occur in 5% of patients on >5 days Heparin
        2. In vivo platelet aggregation
      7. Propylthiouracil
  3. Causes: Platelet impaired function
    1. Common causes
      1. Consider agents that affect coagulation (Heparin, Warfarin)
      2. Aspirin
      3. Nonsteroidal Antiinflammatory Drugs (NSAIDs)
      4. Clopidogrel (Plavix)
    2. Other causes
      1. Antidepressants
        1. Tricyclic Antidepressants
        2. Selective Serotonin Reuptake Inhibitors
      2. Antihistamines
        1. Azatadine
        2. Brompheniramine
        3. Clemastine fumarate
      3. Clofibrate
      4. Dipyridamole
      5. Furosemide (Lasix)
      6. Ginkgo Biloba
      7. Nitrofurantoin (Furadantin)
      8. Propranolol
      9. Sulfinpyrazone
  4. Management
    1. Discontinue offending agent and recheck Platelet Count in 1 week
    2. See Thrombocytopenia
    3. See Thrombocytopenia Causes
  5. Course
    1. Onset within 5 to 7 days of starting the medication
    2. Expect recovery in 7-14 days after discontinuation of medication
  6. References
    1. Kenney (2009) Arch Pathol Lab Med 133(2): 309-14

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