Medicines to cure Plateletopenia

Definition

The blood platelet count is a parameter indicative of blood coagulation capacity. The thrombocytopenia (or thrombocytopenia) outlines a clinical picture characterized by a number of circulating platelets less than 150, 000 units per mm3 of blood, detected on a blood count performed with at least two different anticoagulants. In a healthy adult, the blood platelet count should be between 150, 000 and 400, 000 units per mm3.

Causes

The thrombocytopenia can be classified according to the triggering cause:

From destruction of thrombocytes → serious bacterial infections, abuse of chemotherapy and antibiotics, systemic diseases
Excessive consumption of platelets → vitamin B12 and B9 deficiency, recurrent infections, megaloblastic anemia, eczema, disseminated intravascular coagulation
From thrombocyte seizure → liver cirrhosis

Risk factors: leukemia, immoderate use of NSAIDs, heparins, diuretics, platelet inhibitors (eg. Eptifibatide)

Symptoms

When the values of the circulating platelets are so low (between 50, 000 and 150, 000 units / mm3) but not too much, the thrombocytopenia may be asymptomatic. When the values drop considerably, the patient may complain of bleeding, epitheliums, ecchymoses, gastrointestinal and urinary bleeding, menorrhagia, cerebral haemorrhages.

Complications: platelet hemorrhagic syndrome

The information on Necrosinopenia - Medicines for the Treatment of Plateletsopenia is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Piastrinopenia - Medicines for the treatment of thrombocytopenia.

drugs

The minor thrombocytopenia - when the platelet count is slightly below the normal range (<150, 000 units / mm3) - it does not require any special treatment or care, given that the condition tends to stabilize by itself, except, of course, clearly, for patients complaining of symptoms of appreciable magnitude. The same goes for the thrombocytopenia gravidarum: in many pregnant women (about 10%) there is a noticeable alteration of the platelet count which, generally, does not involve damage to either the mother or the child, and tends to return to the normal range after the birth of the child.

When the thrombocytopenia becomes important, it is necessary to intervene with a pharmacological therapy and / or with a blood transfusion: the therapeutic approach - it is good to remember - should be undertaken only after having identified the triggering cause. For example, thrombocytopenia may depend on the administration of some pharmacological specialties: in this case, the first measure to consider is the suspension of the drug and possibly its replacement with another.

In patients whose thrombocytopenia causes severe bleeding, it is possible to intervene following several different approaches:

Administration of glucocorticoid drugs by oral or intravenous route (to counteract the bleeding)
Intravenous immunoglobulin administration (to treat the thrombocytopenia dependent on an abnormal immune reaction)
Platelet transfusion: reserved for patients with obvious bleeding and a high risk of bleeding
Removal of the spleen: reserved for extreme cases, in which the drugs have not reported observable benefit

Corticosteroids: it is rather complicated to report a precise dosage of taking corticosteroid drugs for the treatment of thrombocytopenia, given the different response of patients to treatment and the variable intensity of symptoms. The following doses are indicative: consult your doctor before taking the drug.

Prednisone (eg. Deltacortene, Lodotra): indicatively, take the drug at a dose of 20-60 mg per day, for severe forms of thrombocytopenia. The drug can also be taken for the treatment of severe forms of thrombocytopenia during pregnancy: in this case, it is advisable to take an active dose of 1mg / kg of extragravid body weight. The treatment must be maintained at the minimum dose necessary to avoid hemorrhagic complications, ie avoiding that the platelets fall below the value of 50, 000 units / mm3.
Dexamethasone (eg. Decadron, Soldesam): Dexamethasone, thanks to its anti-haemorrhagic effect, is indicated to block bleeding caused by thrombocytopenia. As an indication, take the drug at a dose of 40 mg / day for 4 days. Continue with 28 days of suspension and repeat the cycle, respecting the indications prescribed by the doctor.
Cortisone (eg. Cortis Acet, Cortone): for the treatment of idiopathic (immune) thrombocytopenia, it is recommended to take 25-300 mg of drug a day, orally or intramuscularly, splitting the load in one or two doses.
Triamcinolone (eg. Kenacort, Triamvirgi, Aftab): indicated for idiopathic thrombocytopenia at a dose of 16-60 mg per day.

The duration of corticosteroid therapy varies from 5 to 6 months. If the amount of corticosteroids required by the body is high, splenectomy can be considered to escape the side effects that would lead to long-term therapy with steroid drugs.

Enzymatic therapy:

Miglucerase (eg Cerezyme): this is a drug indicated for enzyme therapy, where thrombocytopenia is a characteristic symptom of important pathologies such as Gaucher syndrome. It is not possible to report an indicative dosage, since the precise dosage must be personalized according to the patient. However, the drug is available in powder form for concentrate (solution for infusion): it seems that some patients respond positively by taking 2.5 units / kg, three times a week, up to a maximum of 60U / kg once every 2 weeks . The duration of the IV injection is 1-2 hours. The dosage should be customized for each patient.

Administration of high-dose immunoglobulins (in case of failure to respond to corticosteroids)

Gammaglobulins: immunoglobulins to be administered at high dosage (for severe forms of thrombocytopenia). The drug exerts its therapeutic activity by slowing down the platelet destruction process. For the dosage, consult your doctor.
Anti-Rh immunoglobulins: the administration of these drugs is indicated for patients suffering from refractory plateletopenia; it occurs at the indicative dose of 10-30 mcg / kg per day, for 1-3 consecutive days. This treatment is indicated almost exclusively for Rh positive patients

Immunosuppressive drugs

Azathioprine (eg Azatiopirina, Immunoprin): immunosuppressive drug of the immune system, indicated in the treatment of thrombocytopenia to reduce the administration of steroids, whose long-term side effects could be quite important; indicatively, take azathioprine at a dose of 100 mg a day for 30 days, followed later by 50 mg / day. It is noted that patients treated with this drug react positively in 60% of cases. The drug, if taken at the doses indicated by the doctor, does not cause consistent side effects.
Cyclophosphamide (eg Endoxan Baxter, vial or tablet): is an alkylating and immunosuppressive agent also used in therapy for the treatment of autoimmune thrombopenia. The indicative dose is to take the active ingredient at a dose of 50 mg a day; boluses from 800-1000 mg / v 3 weeks.
Ciclosporina (eg. Sandimmun Neoral): second-line drug for the treatment of immunological platelets. It is recommended to take 3mg / kg of drug a day; the effectiveness of this drug is still doubtful.
Rituximab (eg. MabThera): is a monoclonal antibody used in therapy for the treatment of immunological thrombocytopenia. For the dosage: consult a doctor.
Eltrombopag (eg. Revolade): the drug is indicated for the treatment of autoimmune thrombocytopenic purpura, a variant of thrombocytopenia in which the lack of thrombocytes is due to a peripheral destruction of the same. The eltrombopag is an agonist of thrombopoietin receptors, a drug that promotes platelet formation: in other words, the drug increases the possibility of increasing the platelet count by reducing the risk of bleeding.