DRUG-INDUCED LEUKOPENIA

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LITERATURE REVIEW STUDIES Faguer et al. Gorchynski et al. Matsumoto et al. YEARS STUDIES DESIGN OUTCOME 2007 2008 Case Report Case report of Linezolid-induced pancytopenia in patient infected with MRSA 2010 PK study Renal dysfunction increases linezolid trough level and AUC. Higher drugexposure induces thrombocytopenia Rao et al. 2004 Prospective, Observational study Soriano et al. 2007 Comparative study Recent treatment with vancomycin increased the risk (thrombocytopenia) whose therapy was switched to linezolid compare linezolid alone. Haematological toxicity is directly related to the degree of linezolid exposure 17) Faguer S, Kamar N, Fillola G, Guitard J, Rostaing L. Linezolid-related pancytopenia in organ-transplant patients: Report of two cases. Infection. 2007;35:275–7 18) Gorchynski J, Rose J. Complications of MRSA treatment: Linezolid-induced myelosuppression Presenting with Pancytopenia. West J Emerg Med. 2008 August;9(3):177–8 19) Matsumoto K, Takeshita A, Ikawa K, Shigemi A, Yaji K, Shimodozono Y, et al. Higher linezolid exposure and higher frequency of thrombocytopenia in patients with renal dysfunction. International Journal of Antimicrobial Agents. 2010;36(2):179-81. 20) Rao N, Ziran BH, Wagener MM, Santa ER, Yu VL. Similar Hematologic Effects of Long-Term Linezolid and Vancomycin Therapy in a Prospective Observational Study of Patients with Orthopedic Infections. Clinical Infectious Diseases. 2004 April 15, 2004;38(8):1058-64. 21) Soriano A, Ortega M, García S, Peñarroja G, Bové A, Marcos M, et al. Comparative study of the effects of pyridoxine, rifampin, and renal function on hematological adverse events induced by linezolid. Antimicrob Agents Chemother. 2007;51(7 ):2559-63
VANCOMYCIN Glycopeptide antibiotic 22 G+ve Indication: MRSA (susceptible) infection. Concentration-independent activity Related Problems 23 : Slow bactericidal activity Resistant-development Serious Toxicity • Ototoxicity • Nephrotoxicity • Neutropenia (rare) 22) Rybak MJ, Lomaestro BM, Rotschafer JC, Moellering RC, Craig WA, Billeter M, et al. Vancomycin therapeutic guidelines: a summary of consensus recommendations from the infectious diseases Society of America, the American Society of Health-System Pharmacists, and the Society of Infectious Diseases Pharmacists. Clin Infect Dis. 2009;49(3):325-7. 23) Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant StaphylococcusAureus Infections in Adults and Children. [online] 2011 [cited 2012 Jan]; Available from: URL:http://cid.oxfordjournals.org/content/early/2011/01/04/cid.ciq146.full.pdf
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 and 20: PROGRESS 1/12 • No evidence of at
Page 21 and 22: PROGRESS 23/12 24/12 25/12 28/12
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: LINEZOLID Target: Most Gram +ve ba
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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