الفهرس 
Blood components and physiology of coagulationOnly 14 pages are availabe for public view
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Abstract
Drugs can induce almost the entire spectrum of hematologic disorders in ICU patients, affecting white cells, red cells, platelets and the coagulation system. Drug-induced hematologic disorders include hemolytic anemia, pure red cell aplasia, aplastic anemia, sideroblastic anemia, methemoglobinemia, megaloblastic anemia, neutropenia, neutrophilia, eosinophilia, immune thrombocytopenia, coagulation abnormalities and thrombotic microangiopathies.
The wide spectrum of drug-induced hematologic syndromes is mediated by a variety of mechanisms, including immune effects, interactions with enzymatic pathways and direct inhibition of hematopoiesis.
Providing proof that a drug causes a particular hematologic disorder is frequently impossible. Many patients simultaneously receive multiple drugs, making it difficult to be certain of causality. For some drugs, such as heparin, quinidine and vancomycin, in vitro testing have been performed and mechanisms for cytopenias elucidated. However, such testing is not always possible given that for most there are no standardized, commercially available assays and that reactions may be related to metabolites as opposed to more easily tested parent compounds.
As medicine advances, older drugs become obsolete and are replaced by newer formulations. Many drugs formerly associated with hematologic disorders (e.g., penicillin, alpha methyl-dopa, quinidine and chloramphenicol) are no longer in common use. However, newer drugs are found to be associated with their own potential hematologic disorders (e.g., clopidogrel, linezolid and GPIIb/IIIa inhibitors). Furthermore, in addition to classic drug-induced cytopenias, thrombosis as a common theme with a number of diverse agents (e.g., heparin, COX-2 inhibitors and erythropoietin) was increasingly seeing.
Physicians from a wide variety of specialties need to understand the hematological consequences of drugs and be prepared for the occurrence and correction of these events in their patients.