Thrombocytopenia medical therapy: Difference between revisions
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**Antidote for the offendating agents | **Antidote for the offendating agents | ||
*'''Thrombotic microangiopathy''' | *'''Thrombotic microangiopathy'''<ref name="pmid27149490">{{cite journal| author=Li QY, Yu F, Zhou FD, Zhao MH| title=Plasmapheresis Is Associated With Better Renal Outcomes in Lupus Nephritis Patients With Thrombotic Microangiopathy: A Case Series Study. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 18 | pages= e3595 | pmid=27149490 | doi=10.1097/MD.0000000000003595 | pmc=4863807 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27149490 }} </ref> | ||
**Plasma exchange | **Plasma exchange | ||
**Fresh frozen plasma | **Fresh frozen plasma | ||
*'''Sepsis''' | |||
**Antibacterial agents | |||
**Antiviral agents | |||
**Antifungal agents | |||
*'''Pseudothrombocytopenia''' | |||
**Use of calcium citrate instead of EDTA during blood collection | |||
*'''Immune thrombocytopenia purpura (ITP)''' | *'''Immune thrombocytopenia purpura (ITP)''' | ||
**Corticosteroids | **Corticosteroids: These medications can take up to 48 hours to take effect. Steroids are first-line therapy for ITP. Adverse effects include infection, muscle loss, adipose deposition, cataracts, glaucoma, and Cushing's syndrome. | ||
**Intravenous immunoglobulin | **Intravenous immunoglobulin: This medication has an immediate effect, typically within hours. IV immunoglobulin is first-line therapy for ITP. | ||
**Fostamatinib | ** Rituximab: This is a monoclonal antibody that targets CD20 on B cells and eliminates antibody-producing B cells. It is used as second-line therapy. Adverse effects include infections, hepatitis B reactivation, and progressive multifocal leukoencephalopathy. | ||
**Eltrombopag | **Fostamatinib: This is a spleen tyrosine kinase (SYK) inhibitor that functions by blocking signaling through the Fc receptor in B cells.<ref name="pmid23190017">{{cite journal| author=Baluom M, Grossbard EB, Mant T, Lau DT| title=Pharmacokinetics of fostamatinib, a spleen tyrosine kinase (SYK) inhibitor, in healthy human subjects following single and multiple oral dosing in three phase I studies. | journal=Br J Clin Pharmacol | year= 2013 | volume= 76 | issue= 1 | pages= 78-88 | pmid=23190017 | doi=10.1111/bcp.12048 | pmc=3703230 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23190017 }} </ref> Adverse effects include hypertension, hepatotoxicity, diarrhea, and neutropenia. | ||
**Romiplostim | **Eltrombopag: This is a TPO receptor agonist and is third-line therapy. Liver tests must be monitored while taking eltrombopag. It can cause thrombosis. | ||
**Romiplostim: This is a TPO receptor agonist and is third-line therapy. It can cause thrombosis. | |||
==References== | ==References== | ||
Latest revision as of 01:25, 20 December 2018
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Thrombocytopenia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Thrombocytopenia medical therapy On the Web |
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American Roentgen Ray Society Images of Thrombocytopenia medical therapy |
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Risk calculators and risk factors for Thrombocytopenia medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]
Overview
The treatment of thrombocytopenia depends on the underlying cause.
Treatment
Supportive measures
- Platelet transfusion
Treatment of the underlying cause
- Viral
- Anti-viral medications
- Hydration and supportive measures
- Drug-induced
- Discontinuation of the offending agent
- Antidote for the offendating agents
- Thrombotic microangiopathy[1]
- Plasma exchange
- Fresh frozen plasma
- Sepsis
- Antibacterial agents
- Antiviral agents
- Antifungal agents
- Pseudothrombocytopenia
- Use of calcium citrate instead of EDTA during blood collection
- Immune thrombocytopenia purpura (ITP)
- Corticosteroids: These medications can take up to 48 hours to take effect. Steroids are first-line therapy for ITP. Adverse effects include infection, muscle loss, adipose deposition, cataracts, glaucoma, and Cushing's syndrome.
- Intravenous immunoglobulin: This medication has an immediate effect, typically within hours. IV immunoglobulin is first-line therapy for ITP.
- Rituximab: This is a monoclonal antibody that targets CD20 on B cells and eliminates antibody-producing B cells. It is used as second-line therapy. Adverse effects include infections, hepatitis B reactivation, and progressive multifocal leukoencephalopathy.
- Fostamatinib: This is a spleen tyrosine kinase (SYK) inhibitor that functions by blocking signaling through the Fc receptor in B cells.[2] Adverse effects include hypertension, hepatotoxicity, diarrhea, and neutropenia.
- Eltrombopag: This is a TPO receptor agonist and is third-line therapy. Liver tests must be monitored while taking eltrombopag. It can cause thrombosis.
- Romiplostim: This is a TPO receptor agonist and is third-line therapy. It can cause thrombosis.
References
- ↑ Li QY, Yu F, Zhou FD, Zhao MH (2016). "Plasmapheresis Is Associated With Better Renal Outcomes in Lupus Nephritis Patients With Thrombotic Microangiopathy: A Case Series Study". Medicine (Baltimore). 95 (18): e3595. doi:10.1097/MD.0000000000003595. PMC 4863807. PMID 27149490.
- ↑ Baluom M, Grossbard EB, Mant T, Lau DT (2013). "Pharmacokinetics of fostamatinib, a spleen tyrosine kinase (SYK) inhibitor, in healthy human subjects following single and multiple oral dosing in three phase I studies". Br J Clin Pharmacol. 76 (1): 78–88. doi:10.1111/bcp.12048. PMC 3703230. PMID 23190017.