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Physicians may prescribe romiplostim to patients suffering from chronic idiopathic thrombocytopenia purpura (ITP), a disease characterized by the abnormal destruction of platelets. The action of romiplostim aids in the production of platelets and is usually only prescribed when other treatment methods prove unsuccessful, as the medication may contribute to other disease processes. Individuals taking the drug can also develop serious adverse reactions.
Romiplostim belongs to a class of medications known as thrombopoietic (TPO) mimetics. The thrombopoietic analog attaches to TPO receptor sites, stimulating an intracellular response that leads to the production of megakaryocytes. Megakaryocytes are the precursor cells to platelets.
Patients diagnosed with ITP initially undergo treatment with corticosteroids or immunoglobulins. The spleen may also be removed, as it is the location of platelet destruction. Complete blood counts are monitored before and during the course of treatment. If treatment does not restore patient’s platelet levels, subcutaneous injections of romiplostim may be prescribed.
Those who receive romiplostim injections have an increased risk of developing reticulin fibrous deposits in the bone marrow, and patients previously diagnosed with the condition may experience an exacerbation of the disease. The intracellular processes that occur following TPO receptor site stimulation can also increase the risk of malignancies. Patients must be fully informed of the risks involved in receiving romiplostim. Usually, they must sign a consent form saying that they have been fully informed and agree to the initiation of treatment.
Adverse reactions or side effects commonly associated with romiplostim injections include dizziness, gastrointestinal symptoms, and insomnia. Patients may also experience bone and muscle pain, commonly associated with arthritis, or unusual numbness and tingling of the extremities. Abnormal bleeding or bruising occurring after injections may indicate that the treatment is ineffective. The symptoms may also be indicative of a more serious underlying condition. Discontinuing the medication usually produces an increase in thrombocytopenia symptoms, along with increased abnormal bleeding.
ITP occurs when antibodies attack and destroy platelets. The average person generally has a platelet count of between 150,000 and 450,000 per microliter (mcL). People suffering from ITP may have platelet levels at or below 20,000 per mcL. Without proper platelet formation or normal platelet levels, blood loses its normal clotting ability, and patients experience abnormal bleeding.
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