Anemije izazvane lekovima i značaj farmakološke anamneze

Abstract

There are a number of acquired blood disorders. They are frequently drug-induced. Besides other blood cell lines, drugs can affect red blood cells, too, and evoke different types of anemias. Many tens of drugs are associated with megaloblastic and different types of hemolytic anemias, and also aplastic one. Establishing causality of such adverse drug reaction is not easy. Pathogenesis of drug-induced anemias are represented by immune-mediated, idiosyncratic, and some other types of reactions. In general, some of them are dose dependent, but the other are not. Epidemiological data about red blood cell dyscrasias associated with drugs are very often unharmonized. Since they are originated by various processes, their prognosis and treatment are not uniform. In the aim to avoid the possibility of over-looking drugs as risk factor in inducing anemias, it is necessary to obtain sufficient information about them by introducing pharmacological anamnesis in patient's medical history as its integral part.

Sve se veća pažnja obraća na lekove kao potencijalne uzročnike velikog broja poremećaja. Tome doprinosi bolje poznavanje neželjenih efekta lekova. Više desetina lekova može da izazove hematološke poremećaje. Njihova učestalost zavisi od farmakoloških karakteristika leka, metodologije istraživanja neželjenih efekata lekova i načina njihovog registrovanja. Pored ostalog, lekovi izazivaju različite tipove anemija. Neke od njih mogu da se izbegnu ili ublaže detaljnim uzimanjem od bolesnika farmakološke anamneze, koja podrazumeva ne samo dobijanje podataka o nazivu leka, već i o njegovoj dozi, načinu i dužini primene, kao i o drugim karakteristikama koje su od značaja za ispoljavanje efekata lekova.