Hematological Adverse Drug Reactions

Carey, PJ

doi:10.1002/9781118820186.ch34

Hematological Adverse Drug Reactions

Lookup NU author(s): Dr Peter Carey

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Abstract

© 2014 by John Wiley & Sons, Ltd. All rights reserved. This chapter considers effects on (a) the different cell types that circulate in the peripheral blood; (b) the bone marrow that generates and replenishes those cells, many of which have a short lifespan; and (c) the mechanisms involved in plasma coagulation that maintain hemostasis. One of the adverse drug reactions (ADRs) most feared by both prescribers and manufacturers alike is the unpredictable, idiosyncratic, and unexpected occurrence of peripheral blood cytopenias due to myelosuppression. These are type B reactions according to the classification of Rawlins and Thompson. The chapter concentrates on the rarer type B reactions. It reviews the types of reactions by which drugs may cause cytopenias or affect plasma coagulation. It considers examples of documented ADRs, and talks about strategies for predicting, detecting, and preventing reactions, as well as managing those that do occur.