[Incidence of drug-induced thrombocytopenia in hospitalized patients]. / Incidencia de trombocitopenia inducida por fármacos en pacientes hospitalizados.

OBJECTIVE: To find out the incidence of drug-induced thrombocytopenia and which medications are implicated, and to establish pharmaceutical activity for its prevention and resolution. METHODS: A prospective study was conducted between June and December 2009 in hospitalized patients over 18 years of age with thrombocytopenia. The medications considered to be associated with thrombocytopenia were included in a database drawn up from the bibliography. In a suspected case, the doctor was recommended to discontinue, decrease the dosage or keep the drug under observation; and a follow-up of the patient's platelet count was made in order to classify the relationship between the drug and thrombocytopenia. RESULTS: 273 patients were included (61.5% men) with a mean age of 60 ± 15 years. Mean stay was 18 ± 17 days. TCP incidence was 2.26%. The services most involved were Haematology (56), Intensive Care Medicine (48) and Oncology (40). TCP was moderate in 69% of cases, mild in 26 % and severe in 5%. There were 8 cases of drug-induced thrombocytopenia (0.063% incidence), which were resolved in an average of 7.6 days. The medications related were enoxaparin (2), linezolid (2), tacrolimus (2), thymoglobulin (1) and heparin (1). The doctor was recommended to discontinue the drug (2), decrease the dosage (3) or keep it under observation (3), with 100% acceptance. CONCLUSIONS: Pharmaceutical validation must incorporate an assessment of the platelet count, as it may contribute both to early identification of thrombocytopenia, and to following up platelet counts in patients receiving therapy with thrombocytopenia related drugs.

Incidencia de trombocitopenia inducida por fármacos en pacientes hospitalizados / Incidence of drug-induced thrombocytopenia in hospitalized patients

Objetivo: Los objetivos del estudio fueron conocer la incidencia de trombocitopenia inducida por fármacos, los medicamentos implicados y establecer la actividad del farmacéutico para su prevención y resolución. Método: Se realizó un estudio prospectivo entre Junio y Diciembre de 2009 en mayores de 18 años ingresados con trombocitopenia. Se consideraron medicamentos asociados a trombocitopenia los incluidos en una base de datos elaborada a partir de bibliografía. En caso de sospecha, se recomendaba al médico suspender, disminuir dosis o monitorizar el fármaco y se realizaba el seguimiento del recuento plaquetario para clasificar la relación entre fármaco y trombocitopenia. Resultados: Se incluyeron 273 pacientes (61,5% hombres), edad media 60 ± 15 años. La estancia media fue de 18 ± 17 días. La incidencia de trombocitopenia fue de un 2,26%. Los servicios más implicados fueron Hematología (56), Medicina Intensiva (48) y Oncología (40). La trombocitopenia fue moderada en un 69% de los casos, en un 26 % leve y en un 5% grave. Hubo 8 casos de trombocitopenia inducida por fármacos (incidencia 0,063%), resueltos en una media de 7, 6 días. Los medicamentos relacionados fueron enoxaparina (2), linezolid (2), tacrolimus (2), timoglobulina (1) y heparina (1). Se recomendó al médico suspender el fármaco (2), disminuir la dosis (3) o monitorización (3), con una aceptación del 100%. Conclusiones: La validación farmacéutica debe incorporar la valoración del recuento plaquetario, porque puede contribuir tanto a la identificación precoz de una trombocitopenia, como al seguimiento del recuento plaquetario en pacientes en tratamiento con fármacos relacionados con trombocitopenia (AU)

Objective: To find out the incidence of drug-induced thrombocytopenia and which medications are implicated, and to establish pharmaceutical activity for its prevention and resolution. Methods: A prospective study was conducted between June and December 2009 in hospitalized patients over 18 years of age with thrombocytopenia. The medications considered to be associated with thrombocytopenia were included in a database drawn up from the bibliography. In a suspected case, the doctor was recommended to discontinue, decrease the dosage or keep the drug under observation; and a follow-up of the patient's platelet count was made in order to classify the relationship between the drug and thrombocytopenia. Results: 273 patients were included (61.5% men) with a mean age of60±15 years. Mean stay was 18± 17 days. TCP incidence was 2.26%. The services most involved were Haematology (56), Intensive Care Medicine (48) and Oncology (40). TCP was moderate in 69% of cases, mild in 26 % and severe in 5%. There were 8 cases of drug-induced thrombocytopenia (0.063% incidence), which were resolved in an average of 7.6 days. The medications related were enoxaparin (2), linezolid (2), tacrolimus (2), thymoglobulin (1) and heparin (1). The doctor was recommended to discontinue the drug (2), decrease the dosage (3) or keep it under observation (3), with 100% acceptance. Conclusions: Pharmaceutical vaiicianon musi incorporate an assessment of ihe platelet couni, as II may contribute bolh lo early Identification of thrombocytopenia, and to following up platelet counts in patients receiving therapy with thrombocytopenia related drugs (AU)