The use of sulfasalazine in inflammatory bowel disease has declined due mainly to the fact that it yields the metabolite sulfapyridine ( SP ) which gives rise to side-effects such as agranulocytosis and hypospermia.
42.
Serious side effects include agranulocytosis, aplastic anaemia, hypersensitivity reactions ( like anaphylaxis and bronchospasm ), toxic epidermal necrolysis and it may provoke acute attacks of porphyria, as it is chemically related to the sulfonamides.
43.
Currently, patients must undergo weekly blood tests because Clozaril is associated with an increased risk of agranulocytosis, a condition causing a severe decrease in white blood cells and problems such as fevers, fatigue and bleeding sores.
44.
However, it may be used to treat sulfonamides, there is a significant risk of agranulocytosis, and this, rather than the development of resistance by bacteria, is the main reason for its decline in use.
45.
Effects of long-term colchicine toxicity include agranulocytosis, thrombocytopenia, low white blood cell counts, aplastic anemia, alopecia, rash, purpura, vesicular dermatitis, kidney damage, anuria, peripheral neuropathy, and myopathy.
46.
To be precise, neutropenia is the term normally used to describe absolute neutrophil counts ( ANCs ) of less than 500 cells per microlitre, whereas agranulocytosis is reserved for cases with ANCs of less than 100 cells per microlitre.
47.
Under the current system of weekly monitoring, about 95 percent of patients in the early stages of developing agranulocytosis after the first six months are caught before their white blood cell levels drop below a moderately dangerous level, researchers said.
Clozapine also carries five black box warnings, including warnings for agranulocytosis, CNS depression, leukopenia, neutropenia, seizure disorder, bone marrow suppression, dementia, hypotension, myocarditis, orthostatic hypotension ( with or without syncope ) and seizures.
50.
Owing to the risks associated with clozapine ( e . g . agranulocytosis, diabetes mellitus, etc . ), clinicians often attempt treatment with quetiapine first, although the evidence to support quetiapine's use for this indication is significantly weaker than that of clozapine.
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