Mechanisms of ADR-Affecting Haemostasis

| Home | | Pharmacovigilance |

Chapter: Pharmacovigilance: Gastrointestinal ADRs

Clearly antithrombotic drugs such as oral and parenteral anticoagulants, thrombolytic and antiplatelet agents compromise haemostatic mechanisms at therapeutic doses as well as in overdose, in a manner analogous to the ‘type A’ occurrence of cytopenias with cytotoxic agents.


MECHANISMS OF ADR-AFFECTING HAEMOSTASIS

Clearly antithrombotic drugs such as oral and parenteral anticoagulants, thrombolytic and antiplatelet agents compromise haemostatic mechanisms at therapeutic doses as well as in overdose, in a manner analogous to the ‘type A’ occurrence of cytopenias with cytotoxic agents. Interactions of drugs disrupting the therapeu-tic control of oral anticoagulant treatment are another important cause of ADR. These reactions will not however be considered here.

Haemostasis is obviously affected by ADRs caus-ing thrombocytopenia, as discussed in the previous section.

Other drugs may predispose to haemorrhage by unin-tended effects on platelet function, by affecting the  production of plasma coagulation factors or by caus-ing the consumption of coagulation factors (as in DIC). A predisposition to thrombosis may be caused by acquired resistance to the anticoagulant effect of activated protein C (APC) (e.g. oestrogen-containing medications) or by the stimulation of acquired anti-bodies to phospholipid (the ‘lupus anticoagulant’ phenomenon).

Table 34.2 lists mechanisms of haemostatic ADRs (for non-antithrombotic drugs) together with examples of implicated agents.



Contact Us, Privacy Policy, Terms and Compliant, DMCA Policy and Compliant

TH 2019 - 2022 pharmacy180.com; Developed by Therithal info.