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Drug Induced Haematologic Disorders Aplastic anemia (Pancytopenia) : The drugs which cause one marrow aplasia include alkylating agents, antimetabolites, antibiotics, vinca alkaloids.The antibacterial drug, chloramphenicol phenybutazone, oxyphenbutazone and indomethacin are the most common causes of aplastic anemia.Chloramphenicol causes the bone marrow toxicity in two ways.One is bu inhibiting the mitochoncrial protein synthesis and the other type is much serious causing true bone marrow aplasis which cannot be prevented by chloramphenicol withdtawl. Agranulocytosis: It is another drug induced condition due to destruction of granulocytic leucocytes by the antibodies. This condition may happen due to toxic depression of bone marrow /stem cells after prolonged administration of drug inlarge dose. Drugs which induce agranulocysis include sulfonamides,sulfonylureas, phenothiazines antithydroid drugs, phenyl butazone and semisynthetic penicillins, antitubercular drugs. Thrombocytopenia: The reduction in the count of thrombocytes (Plarelets) is due to the bone marrow suppression and the destruction of platelets.The cytotoxicdrugs chloramphenicol, sulphanomides, phenothiazines, antiepileptics causes the bone marrow suppression.The drugs which form the immune complexes that destroy platelets are quinine, quindine, aspirin, methyldopa, cardiotonics acetazolamide. Haemolytic anemia : The haemolytic anemia may occur due to genetic abnormality or acquiredimmunogical abnormality Haemolysis occurs in patients with deficiency ofglucose-6-phosphate dehydrogenase.The immune haemolytic reaction takes placewith methyldopa, levodopa and mefenamic acid and streptomycin.These drugs bind to the proteins in the R.B.C. and causes haemolysis.