Page 297 - Clinical Hematology_ Theory _ Procedures ( PDFDrive )

CHAPTER 15 ■ Macrocytic and Megaloblastic Anemias 281

Drugs That Cause

BOX 15.1 TABLE 15.1
Megaloblastic Anemia

Mechanism
Examples of Nonmegaloblastic Macrocytic of Action Type of Medication Examples

Anemias

Modulates Immunomodulator Azathioprine
A m purine

M m metabolism Antineoplastic agent Thioguanine

A m Immunomodulator and Methotrexate

H m m antineoplastic agent

P m m Interferes with Antineoplastic agent Hydroxyurea

O F m A m pyrimidine Anesthetic agent Nitrous oxide

M m synthesis

A m Decreased Organic compound Isoniazid

A q m absorption of

H m ( - vitamin B Alkaloid extract Colchicine

m I III) 12

D m -B k m Increased Inorganic compound Sodium

O C excretion of nitroprusside

H m vitamin B 12

R Destruction of Gas Nitric oxide

S m ( m , vitamin B 12

mm ) Decreased Hormone Estrogen

M m G JP, . ( .), Wintrobe’s Clinical Hematology, absorption Antibiotics Ampicillin and

, P , PA: L W m & W k , :V . , of folic acid other penicillins

, . .
Erythromycin

Tetracycline

Antiseizure Phenobarbital
m . MCV m

L. Antimalarial Quinine

Chloroquine

MEGALOBLAS IC ANEMIAS Folate Antineoplastic agent Pemetrexed

analogue Antimalarial Pyrimethamine

M m z activity

m , m m - Antibacterial Trimethoprim

, Immunomodulator and Methotrexate

m . L k m- antineoplastic

m . A m Reference adapted from Hesdorffer CS, Longo DL. Drug-induced megalo-

, ineffective erythropoiesis blastic anemia, N Engl J Med, 373(17):1650–1651, Table 1, 2015.

m m

m .

T m megaloblastic m m I z m m -

m . D - m m

m DNA . M m , m -

k m . M m , m m m

m z m m ( . ).

intramedullary hemolysis. D m m m -

M , m m m B . S

q m , C ( m B ), m DNA

m m . T m - k

( ) m . - m , DNA , - m

m k m DNA. T m

. m m - m m . O -

vitamin B olic acid de iciency, x .
12
R m m -

. m m m