#TITLE_ALTERNATIVE#

• Main Author: SAIDAH MUTHMAINAH (NIM : 30712301 ), SITI
• Format: Dissertations
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/31008
• Institution: Institut Teknologi Bandung

<p align="justify"> Thrombocytopenia is a condition of decreased platelet count below the normal value caused by reduced formation or increased destruction of the platelet. Clinical diagnosis of thrombocytopenia is based on the signs and laboratory findings. The presence of thrombocytopenia in patents can be associated with the use of certain drugs. <br /> <br /> This study was conducted to investigate the association between the use of ceftriaxone, ketorolac and ranitidine as single agent or in combination and the onset of thrombocytopenia. Case control study was used in the study using patients to determine the odds ratio of the drugs-thrombocytopenia association. Association between ceftriaxone, ketorolac and ranitidine and thrombocytopenia was also studied in animal model. In the latter study, the probable mechanisms were assessed by observation of immunological reaction and bone marrow examination. <br /> <br /> The case control study revealed an odds ratio of 2.4 with confident interval of 6.39, suggesting an association between the drugs exposure and thrombocytopenia. <br /> <br /> The results of the test in mice induced for 7 days with drugs showed significant decrease (P<0.05) in the group receiving single ketorolac and combination of ceftriaxone, ketorolac and ranitidine after 2 days. As for measurement after 7 days, the decrease was observed in mice that received single ranitidine and a combination of ceftriaxone and ranitidine. In the mice induced for 14 days, single administration of ceftriaxone, ketorolac and the combinations of these three drugs significantly decreased platelet count (P<0.05) after the 5th day. Whereas after day 14, decrease in platelet count occurred in the group of mice given single ranitidine and that receiving combination of the three drugs. <br /> <br /> Immunological examination demonstrated that mice treated with ranitidine or ketorolac had decreased concentration of glycoprotein V which may lead to the lysis or destruction of platelet and the consequent decrease in platelet count. As for the marrow examination of the femur bone, it was found that mice induced by combination of ranitidine and ceftriaxone or ranitidine and ketorolac showed decreased number of megakaryocytes, the platelet precursor, which could lead to the decrease in platelet formed. <p align="justify">