Pediatric Nursing Q 155

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Mr. and Mrs. Robertson’s son was diagnosed with idiopathic thrombocytopenic purpura. They should be aware that the drug to be avoided is:

  

     A. Acetaminophen

     B. Aspirin

     C. Codeine

     D. Morphine

    

    

Correct Answer: B. Aspirin

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Aspirin exerts an antiplatelet action and therefore may increase platelet destruction in ITP. Aspirin inhibits platelet function by acetylating platelet cyclooxygenase, increasing the risk of bleeding because it adds a prolonged platelet functional defect to the quantitative defect already present from the severe thrombocytopenia.

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Option A: Acetaminophen (paracetamol) is widely used for postoperative analgesia. Its mechanism of action is inhibition of prostaglandin synthesis in the central nervous system, and acetaminophen is traditionally not considered to influence platelet function.

Option C: Non-steroidal anti-inflammatory drugs (NSAID), such as ibuprofen (Nurofen, etc.) should also be avoided for similar reasons. Paracetamol or codeine can be recommended for adults.

Option D: Although it has a very low incidence worldwide, morphine-induced thrombocytopenia can occur in some patients especially with higher doses. From eHealthMe study, from the FDA reports published On January 26, 2015: There were 48,666 people reported to have side effects when taking morphine. Among them, 156 people (0.32%) have Heparin-induced Thrombocytopenia.

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