Page 2099 - Williams Hematology ( PDFDrive )

2074 Part XII: Hemostasis and Thrombosis Chapter 121: Acquired Qualitative Platelet Disorders 2075

TABLE 121–1. Acquired Qualitative Platelet Disorders TABLE 121–2. Drugs That Affect Platelet Function
Drugs that affect platelet function Nonsteroidal antiinflammatory drugs
Aspirin and other nonsteroidal antiinflammatory drugs Aspirin, ibuprofen, sulindac, naproxen, meclofenamic
P2Y antagonists (clopidogrel, prasugrel, ticagrelor) acid, mefenamic acid, diflunisal, piroxicam, tolmetin,
12 zomepirac, sulfinpyrazone, indomethacin, phenylbutazone,
PAR1 thrombin receptor antagonist (vorapaxar) celecoxib
Integrin α β receptor antagonists (abciximab, eptifibatide, P2Y antagonists
IIb 3
12
tirofiban) Clopidogrel, prasugrel, ticagrelor
Drugs that increase platelet cyclic adenosine monophosphate PAR1 receptor antagonist
Antibiotics Vorapaxar
Anticoagulants and fibrinolytic agents Integrin α β antagonists
IIb 3
Cardiovascular drugs Abciximab, eptifibatide, tirofiban
Volume expanders Drugs that affect platelet cyclic adenosine monophosphate levels
Psychotropic agents and anesthetics or function
Oncologic drugs Prostacyclin, iloprost, dipyridamole, cilostazol
Foods and food additives Antibiotics
Hematologic disorders associated with abnormal platelet function Penicillins
Chronic myeloproliferative neoplasms Penicillin G, carbenicillin, ticarcillin, methicillin, ampicillin,

Leukemias and myelodysplastic syndromes piperacillin, azlocillin mezlocillin, sulbenicillin, temocillin
Dysproteinemias Cephalosporins
Acquired von Willebrand syndrome Cephalothin, moxalactam, cefoxitin, cefotaxime, cefazolin
Systemic disorders associated with abnormal platelet function Nitrofurantoin
Uremia Miconazole
Antiplatelet antibodies Anticoagulants, fibrinolytic agents, and antifibrinolytic agents
Cardiopulmonary bypass Heparin
Liver disease Streptokinase, tissue plasminogen activator, urokinase
Disseminated intravascular coagulation ε-aminocaproic acid
Infection with HIV Cardiovascular drugs
Nitroglycerin, isosorbide dinitrate, propranolol, nitroprusside,
nifedipine, verapamil, diltiazem, quinidine
Volume expanders
fibroblasts, and monocytes by growth factors, cytokines, endotoxin,
and hormones. Platelets express only COX-1, whereas endothelial cells Dextran, hydroxyethyl starch
5
can express both COX-1 and COX-2. In the cardiovascular system, Psychotropic drugs and anesthetics
7,8
COX products regulate complex interactions between platelets and Psychotropic drugs
the vessel wall. The platelet product of COX-1 mediated prostaglandin Imipramine, amitriptyline, nortriptyline, chlorpromazine,
synthesis, thromboxane A (TXA ), produces vasoconstriction and is a promethazine, fluphenazine, trifluoperazine, haloperidol
2
2
receptor-mediated agonist for platelet aggregation and secretion. Thus, Anesthetics
4
inactivation of COX-1 by aspirin prevents platelet synthesis of TXA , Local
2
thereby inhibiting platelet responses that depend on this substance.
Accordingly, platelet responses to adenosine diphosphate (ADP), epi- Dibucaine, tetracaine, Cyclaine, butacaine, nupercaine,
procaine, cocaine
nephrine, low doses of collagen and thrombin, and arachidonic acid
are affected (arachidonic acid completely), but there is almost no effect General
on the responses to higher doses of collagen or thrombin. On the Halothane
9,10
other hand, the endothelial cell prostaglandin (PG) product, prostacy- Oncologic drugs
clin (PGI ), produces smooth muscle cell relaxation and vasodilation Mithramycin, daunorubicin, BCNU, ibrutinib
2
and increases the platelet content of cyclic adenosine monophosphate Miscellaneous drugs
(AMP), thereby decreasing overall platelet reactivity. 11
Platelet PG synthesis in an adult is nearly completely inhibited by a Ketanserin
single 100-mg dose of aspirin or by 30 mg taken daily for 7 to 10 days. Antihistamines
4
Although single doses of aspirin irreversibly inhibit platelet and endo- Diphenhydramine, chlorpheniramine, mepyramine
thelial cell COX, they have no lasting effect on PG synthesis by endo- Radiographic contrast agent
12
thelial cells because of the ability of these cells to synthesize additional Iopamidol, iothalamate, ioxaglate, meglumine diatrizoate,
COX unaffected by aspirin. In vitro studies also suggest that the pres- sodium diatrizoate
13
ence of erythrocytes contributes to agonist-stimulated platelet reactiv- Foods and food additives
ity, an effect that can be inhibited by aspirin at doses greater than those
14
required to inhibit platelet COX-1. A meta-analysis of clinical trials ω-3 Fatty acids, ethanol, Chinese black tree fungus, onion
15
indicates that aspirin doses varying from 50 to 1500 mg daily are equally extract ajoene, cumin, turmeric

Kaushansky_chapter 121_p2073-2096.indd 2074 9/18/15 10:28 AM