Blood is an opaque, mobile fluid connective tissue that is mesodermal in origin. It consists of plasma, blood cells and platelets amongst a diverse array of molecules and ions. A large number of drugs, administered for treatment of various disorders come in direct contact with blood whether taken orally or injected intravenously. A multitude of possible drug interactions pose a serious problem especially to people who take prescription medicines for various diseases simultaneously. Some of these drugs may cause adverse effects on blood cells and lead to various blood disorders. Blood disorders are rare, yet extremely serious and may even prove fatal.

Types of Drug induced blood disorders: In our body, red bone marrow contains pluripotent stem cells which differentiate and mature to form various types of blood cells. Different drugs show different effects on various cells at different stages of cell development. Blood disorders can be characterized depending upon where and at what point in the cellular development the drug acts upon. Some of the common blood disorders include, but are not limited to:

Aplastic anemia: It is a form of anemia characterized by an abnormal deficiency in all blood cells resulting from failure of the bone marrow. It is a rare disorder of haemopoietic stem cells which was first found to be caused by the use of Chloramphenicol. Various non-steroidal anti-inflammatory drugs, disease modifying anti-rheumatic drugs have also been found to cause aplastic anemia.

Agranulocytosis: It is an acute blood disorder which is characterized by severe reduction in granulocytes and neutrophils. It is often caused by radiation and chemotherapy which are known to cause reduction in granulocytes and neutrophil counts. Some anti-thyroid drugs like carbimazole & propylthiouracil also increase the risk of Agranulocytosis.

Thrombocytopenia: It is a blood disease characterized by an abnormally small number of platelets in the blood. Heparin is one of the well known drugs associated with severe reduction in platelet count.

Hypertension: It is a common disorder in which blood pressure remains abnormally high (a reading of 140/90 mm Hg or greater). It is also called as high blood pressure. Amphetamines, corticosteroids, estrogens are some of the drugs that can lead to hypertension.

Symptoms:

The symptoms of drug induced blood disorders vary depending upon the type of drug used and the drug effects they produce. However, some generalized symptoms of various common blood disorders may include bleeding gums, chest pain, dry cough, dyspnoea (difficult or labored respiration), fatigue, malaise, pallor (unnatural lack of color in the skin), stomatitis (Inflammation of the mucous membrane of the mouth), lassitude (weakness characterized by a lack of energy), lymphadenopathy (Chronic abnormal enlargement of the lymph nodes), petechiae i.e. minute red or purple spot on the surface of the skin as the result of tiny hemorrhages of blood vessels in the skin, to name a few.

Treatment:

Treatment of blood disorders requires special expertise. Aplastic anemia may require Immunosuppressive therapy and bone marrow/stem cell transplant whereas Corticosteroid therapy is beneficial in case of Hemolytic anemia. As an immediate measure, use of suspected drug should be discontinued and short term supportive treatments should be given to the patients.