As a result of the suspicions that he delivered the thrombosis through the administration of the AstraZeneca vaccine, he would like to record that he was involved in drug dealing with the thrombocytopenia induced by pharmacists (TCPIF). TCPIF patients present with a reduction in plaque count of 5 to 10 days after pharmacy administration with a hemorrhagic risk mayor.
The diagnosis, in addition, is a challenge, because the majority of hospitalized patients have multiple medications and have comorbidities that can also cause thrombocytopenia.
Heparina
The European Medicines Agency (EMA) has announced that it is possible to associate the infrequent cases of blood clots and low levels of plaque in the blood with the AstraZeneca vaccine, which should appear as a “very rare 100” secondary effect. .
The first cases of thrombosis during the evacuation with AstraZeneca is detected between 3 and 14 days after dose administration. Patients present with a “very intense cabbage pain that is painful and can not be improved with analgesics”, including cases where there are “vomiting or irregular blood clots”. This ultimate affection is what is known clinically as thrombocytopenia.
Has more than 300 pharmacies involved in TCPIF. A systematic review of individual patient data found that pharmacies notified to the mayor frequently with a definitive causal relationship or probable thrombocytopenia quinine, quinidine, trimethoprima / sulfamethoxazole, vancomicin penicillin. as well as the inhibitors of glycoprotein IIb / IIIa (GPIIb / IIa) abciximab, tirofiban and eptifibatida.
The review included 273 patients (61.5% men), media age 60 ± 15 years. The media distance is 18 ± 17 days. The incidence of thrombocytopenia is 2.26%. The most involved services are Hematology (56), Intensive Care (48) and Oncology (40). Thrombocytopenia was moderate in 69% of cases, in 26% lev and in 5% severe.
Hubo 8 cases of drug-induced thrombocytopenia (0.063% incidence), resulting in a media of 7, 6 days. The related drugs are fueron enoxaparina (2), linezolid (2), tacrolimus (2), timoglobulin (1) and heparin (1). It is recommended that the doctor suspend the pharmacy (2), reduce the dose (3) or monitor (3), with a 100% acceptance.
Prohibition of probes, the most common pharmacy involved in DITP suele ser heparina. The potentially fatal thromboembolic complications are common in patients with heparin-induced thrombocytopenia (TIH). Thrombocytopenia can occur in 10 to 30% of patients treated with heparin as a result of an obvious affectation of the immunological system.
The incidence of TCPIF is not known for accuracy, it is that the notification of cases is voluntary and has not been carried out studies designed at this end. Based on various epidemiological studies in the United States and Europe, the minimum incidence is estimated at around 10 cases per million inhabitants / year.
On the other hand, the incidence of TCPIF varies from drug to drug, with values of up to 5% up to 40% in patients receiving heparin, while for other pharmacies it is lower than 1%. The pharmacies that have been most frequently associated with TCPIF appearing are alkaloids of Cinchona (quinine / quinidine), sulfonamides, AINEs, diuretics, anticonvulsants and tuberculostatics.
