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Related Experiment Videos

Impaired platelet function associated with parenteral nafcillin.

E K Jeter1, A Scott, J Kizer

  • 1Department of Pathology/Laboratory Medicine, Medical University, Charleston, SC 29425.

Annals of Clinical and Laboratory Science
|January 1, 1990
PubMed
Summary

Nafcillin, an antibiotic, can cause acquired platelet dysfunction, leading to bleeding complications. Discontinuation of nafcillin resolved bleeding, confirming its role in platelet defect.

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Area of Science:

  • Neuroscience
  • Hematology
  • Pharmacology

Background:

  • Subarachnoid hemorrhage (SAH) is a critical neurological condition often requiring surgical intervention.
  • Anterior communicating artery aneurysms are a common cause of SAH, necessitating prompt management.
  • Postoperative complications, including hematomas and bleeding disorders, can arise after neurosurgery.

Observation:

  • A patient developed epistaxis and bleeding from surgical sites after receiving nafcillin for empiric coverage.
  • Recurrent subdural and epidural hematomas occurred, requiring further emergent craniotomies.
  • Platelet function studies revealed a qualitative platelet defect with prolonged bleeding time and abnormal aggregation/ATP release, despite a normal platelet count.

Findings:

  • Nafcillin therapy was identified as the cause of acquired qualitative platelet dysfunction.

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  • Discontinuation of nafcillin led to the resolution of clinical bleeding.
  • Subsequent tests confirmed nafcillin-induced platelet dysfunction, highlighting a drug-induced hemostatic defect.

    • Implications:

    • Clinicians should consider nafcillin-induced platelet dysfunction in patients presenting with unexplained bleeding post-administration.
    • Awareness of this adverse effect is crucial for neurosurgical patients, particularly those with pre-existing bleeding risks.
    • Early recognition and discontinuation of the offending agent can prevent severe hemorrhagic complications and improve patient outcomes.