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Doctors' Answers to "Frequently Asked Questions" - Nosebleeds
Low Platelets [posted 8/13/98]
Answer: 150,000 would be sufficient to clot and would not be the cause of his nose bleed assuming they are working correctly. Your husband should avoid aspirin and non-steroidal antiinflammatory type drugs. Also, a test called a bleeding test will test whether they are working correctly. However, bleeding normally does not occur with thrombocytopenis (low platelets) until the number is below 60,000 and usually below 20,000. However, if the doctor is correct they will need to be checked. Has he had a previous count? If he is always there it is of less concern than if it is a new problem. However, I have lots of patients at this level without any particular cause or sequelae. It needs follow up, but not necessarily a big deal.
Nosebleeds and Cephalexin [posted 8/4/98]
Answer: Platelets are what is responsible for the clotting. For the antibiotic to explain the problem, one would have to come up with some mechanism explaining either inhibition of function or lowering of numbers acutely. Then the problem would pass 2-3 hours later. Offhand, I can't come up with a mechanism to explain this. Doesn't mean the antibiotic is not the cause, but would need further evaluation.
Daypro & Sular
Answer: Any of the non-steroidal anti-inflammatories will increase the risk of bleeding. Whether it is arterial or venous is related to the risks of the individual. These drugs inhibit platelets in a reversible fashion(aspirin is irreversible) and the platelets will not work as well(or at all) the day that the drug is taken. Therefore, if you initiate a bleed(not the drugs fault)it will continue to bleed-whereas if the platelets worked it would stop on its own. These drugs can initiate ulcers in the stomach and esophagus-but not start bleeding in other parts of the body. They don't start the bleed; but, inhibit your bodies ability to stop it.