Agranulocyocytosis: A acute condition involving a severe and dangerous leukopenia. The absence of Granulocytes.

1. AGRANULOCYTOSIS
Presented by-
Dr. VINOD shukla

2. Agranulocytosis:
A acute condition involving a
severe and dangerous
leukopenia. The absence of
Granulocytes

3. Signs and symptoms of Agranulocyctosis:
 History of exposure to
causative agents.
 Sudden or gradual onset.
 Condition begins with
sore throat, fever, and
often rigors.
 Rapidly advancing
necrotic ulceration in the
throat and mouth.
 Death from toxaemia and
septicaemia.
 Psychotropics drugs
which can cause
agranulocyctosis include
Clozapine,
CPZ,antiepileptics,
antidepressants
mitazapine and
Imipramine.

4. Diagnosis:
Complete blood count
Neutrophil count below 500
Need to exclude other pathologies with
similar presentation e.g. aplastic anaemia

5. Treatment:
Cease the offending agent.
Close monitoring and serial blood counts.
Advice on significants of fever.
Urgent treatment of infection with antibiotic.
Supportive treatments.

6. Clozapine
Atypical antipsychotic drugs differ from
traditional antipsychotic agents in their
ability to act as dopamine receptor and
serotonin receptor blockers. This
simultaneous blocking may account for
the increased efficacy of these drugs in
improving the negative symptoms of
schizophrenia.

7. Clozapine
Clozapine can cause serious, life-
threatening adverse effects of
agranulocyosis.
In the UK, the risk of death from
agranulocytosis, is 1 in 10,000 patients
exposed to clozapine.
Risk is well managed by the approved
clozapine monitoring system.

8. Clozapine
Clozapine has been associated with
myocarditis and cardiomyopathy.
Risk of death from either of these causes
is estimated by the data to be 1 in 1300.
Myocarditis seems to occur within 6 to 8
weeks of starting clozapine.
Due to risk of agranulocytosis clozaril
should not be combined with
Carbamazepine.

9. Anticholinergics Effects
Dry mouth, blurred vision,
urinary retention, and
constipation.

10. Action of Anticholinergics
Anticholinergics block nerve impulses in
the parasympathetic nervous system or
counteract the effects of acetylcholine.
Effects include dilation of the pupils,dry
mouth, quickening of heart rate, reduction
in gastric juice secretion, and retention of
urine.

11. Treatment
Change to less
anticholinergic drug.
Reduce combination
therapy.
Stop offending drug.