Table 1.

Initial treatment of critical bleeding in patients with ITP

AgentMechanism of actionOnset of effectRisks
IVIG Interferes with FcR-mediated opsonization of antibody-coated platelets by macrophages Hours Volume overload
Headache
Fever 
Glucocorticoids Inhibits macrophage-mediated platelet clearance
Decreases IgG production 
Days Elevated blood glucose
Hypertension
Steroid psychosis 
Platelet transfusions Immediate supply of platelets Immediate Short duration of effect
Transfusion reaction
Bacterial infection from contaminated products 
Tranexamic acid Stabilizes hemostatic clots Immediate Headache
Nausea 
AgentMechanism of actionOnset of effectRisks
IVIG Interferes with FcR-mediated opsonization of antibody-coated platelets by macrophages Hours Volume overload
Headache
Fever 
Glucocorticoids Inhibits macrophage-mediated platelet clearance
Decreases IgG production 
Days Elevated blood glucose
Hypertension
Steroid psychosis 
Platelet transfusions Immediate supply of platelets Immediate Short duration of effect
Transfusion reaction
Bacterial infection from contaminated products 
Tranexamic acid Stabilizes hemostatic clots Immediate Headache
Nausea 
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