DRUG-INDUCED LEUKOPENIA

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PROGRESS 9/12 • High BP (191/99mmHg) – restart prazocin 13/12 • Reducing trend of TWBC (3.66). Azathioprine was off. • KIV MMF. 18/12 • Hypotension (103/64 mmHg) – withold Prazocin 19/12 • Hypotension, • Completed linezolid. Vancomycin and rifampicin combination was started (VISA treatment)
PROGRESS 23/12 24/12 25/12 28/12 • Haemotypsis and bruises (INR 2.55, aPTT 71.5s)– Warfarin withold, 6 unit FFP was transfused, target INR 1.5-2 • SOB, Sudden onset of desaturation secondary to pulmonary haemorrhage, diagnose pulmonary embolism – KIV intubation if worsening. • Respiratory failure (I) precipated by fluid overload and anemia. • Oral candiasis – Syr Nystatin was given • Hyperkalaemia (6.6mmol/L) – Lytic cocktail stat. • Condition improving • Reducing trend of TWBC – Drug related ? (Vancomycin / Linezolid / Rifampicin / Azathioprine) • Off Vancomycin and rifampicin, restart linezolid.
Page 1 and 2: UNIT KAJIAN DAN MAKLUMAT DRUG (UKMD
Page 3 and 4: OBJECTIVES
Page 5 and 6: INTRODUCTION
Page 7 and 8: Adverse Drug Reaction 2 Non-Immunol
Page 9 and 10: INTRODUCTION Drug-induced Leukopeni
Page 11 and 12: CASE PRESENTATION
Page 13 and 14: HISTORY OF CURRENT ILLNESS Product
Page 15 and 16: PAST MEDICATION HISTORY DRUGS T. Pr
Page 17 and 18: SYSTEM REVIEW (ON ARRIVAL) BP HR T
Page 19: PROGRESS 1/12 • No evidence of at
Page 23 and 24: MEDICATIONS - ANTIBIOTIC DRUGS INDI
Page 25 and 26: MEDICATIONS - OTHERS DRUGS INDICATI
Page 27 and 28: 20 40 60 80 100 120 140 160 180 200
Page 29 and 30: BLOOD CULTURE & SENSITIVITY Date Sa
Page 31 and 32: BLOOD CULTURE & SENSITIVITY Date Sa
Page 33 and 34: HAEMATOLOGICAL- Hb 4.0 9.1 7.3 7.0
Page 35 and 36: INR COAGULATION - INR 4 3.5 3.47 3.
Page 37 and 38: 30-Nov 01-Dis 02-Dis 03-Dis 04-Dis
Page 39 and 40: CURRENT DIAGNOSIS (as of 4/1/2012)
Page 41 and 42: PHARMACEUTICAL CARE ISSUES Leukope
Page 43 and 44: 30-Nov 01-Dis 02-Dis 03-Dis 04-Dis
Page 45 and 46: NARANJO ADR PROBABILITY SCALE Quest
Page 47 and 48: LINEZOLID Target: Most Gram +ve ba
Page 49 and 50: VANCOMYCIN Glycopeptide antibiotic
Page 51 and 52: AZATHIOPRINE 13 Immunosuppressant
Page 53 and 54: MOST PROBABLE ? By Naranjo Score:
Page 55: CONCLUSION A case on probable drug

DRUG-INDUCED LEUKOPENIA

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