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Drug Induced Platelet Dysfunction
Aka: Drug Induced Platelet Dysfunction, Drug Induced Platelet Destruction, Drug induced Thrombocytopenia, Drug-Induced Thrombocytopenia, Thrombocytopenia caused by Medications
- See Also
- Platelet Bleeding Disorders
- Thrombocytopenia
- Thrombocytopenia Causes
- Causes: Thrombocytopenia
- Chemotherapeutic agents
- Alkylating Agents
- Antimetabolites
- Interferon
- Fludarabine
- Oxaliplatin
- Antibiotics
- Sulfonamides (e.g. Bactrim)
- Penicillins
- Cephalosporins
- Rifampin
- Vancomycin
- Fluoroquinolones
- Linezolid
- Ganciclovir
- Cardiovascular Agents
- Abciximab (ReoPro)
- Eptifibatide (Integrilin)
- Tirofiban
- Digoxin
- Methyldopa
- Procainamide
- Cinchona alkaloids (Quinidine, Quinine, Tonic Water)
- Thiazide Diuretics (Hydrochlorothiazide, Chlorthalidone)
- H2 Antagonists
- Cimetidine (Tagamet)
- Ranitidine (Zantac)
- Neuropsychiatric agents
- Barbiturates
- Phenytoin (Dilantin)
- Valproic Acid (Depakene)
- Carbamazepine (Tegretol)
- Miscellanous Agents
- Chronic Alcohol Abuse
- Estrogens
- Gold Salts
- MMR Vaccine
- Sulfasalazine (Azulfidine)
- Propylthiouracil
- Heparin Induced Thrombocytopenia
- Occur in 5% of patients on >5 days Heparin
- In vivo platelet aggregation due to immune complexes against platelet factor 4 (PF4) and Heparin
- Causes: Platelet impaired function
- Common causes
- Consider agents that affect coagulation (Heparin, Warfarin)
- Aspirin
- Nonsteroidal Antiinflammatory Drugs (NSAIDs)
- Clopidogrel (Plavix)
- Other causes
- Antidepressants
- Tricyclic Antidepressants
- Selective Serotonin Reuptake Inhibitors
- Antihistamines
- Azatadine
- Brompheniramine
- Clemastine fumarate
- Clofibrate
- Dipyridamole
- Furosemide (Lasix)
- Ginkgo Biloba
- Nitrofurantoin (Furadantin)
- Propranolol
- Sulfinpyrazone
- Management
- Discontinue offending agent and recheck Platelet Count in 1 week
- See Thrombocytopenia
- See Thrombocytopenia Causes
- Course
- Onset within 5 to 7 days of starting the medication
- Expect recovery in 7-14 days after discontinuation of medication
- References
- Merrill and Gillen (2016) Crit Dec Emerg Med 30(3): 3-8
- Kenney (2009) Arch Pathol Lab Med 133(2): 309-14 [PubMed]