Evaluation and management of drug-induced thrombocytopenia in the acutely ill patient

The numerous drugs to which the acutely ill are exposed place these patient s at a significant risk of developing drug-induced thrombucytopenia. Such p atients tend to have preexisting hemostatic defects that place them at addi tional risk of complications as a result of the drug-induced thrombocytopen ia. The clinical challenge is to provide rapid identification and removal o f the offending agent before clinically significant bleeding or, in the cas e of heparin, thrombosis results, Drug-induced thrombocytopenic disorders c an be classified into three mechanisms: bone marrow suppression, immune-med iated destruction, and platelet aggregation. Clinical characteristics. prel iminary laboratory findings, and drug history specific to the mechanisms ca n assist clinicians in rapidly isolating the causative drug.