Mrs. ryan, a middle-aged woman, appears at the clinic complaining of multiple small hemorrhagic spots in her skin and severe nosebleeds. while taking her history, the nurse notes that mrs. ryan is taking apronal (a sleeping medication) because she has problems getting to sleep at night. this drug is known to be toxic to red marrow. using your knowledge of physiology, explain the connection between the bleeding problems and the taking of apronal.

The petechiae on Mrs. Ryan skin says that she has a deficiency in the number of circulating platelets called thrombocytopenia, which causes bleeding from small blood vessels all over the body. Thrombocytopenia can arise from any condition that destroys red blood marrow, such as the Benzene in the rubber glue at her workplace.

Explanation: Apronal, a brand name of apronalide, is a drug from the class sedative/hypnotics wherein the main action is sedation. This drug is used to treat mild to moderate pain (from headaches, menstrual periods, toothaches, backaches, osteoarthritis, or cold/flu aches and pains) and to reduce fever. The side effect of this drug is bone marrow toxicity, especially in the red bone marrow. In the red bone marrow occurs the production of most blood products, particularly of those in myeloid origin (red blood cells, white blood cells, and platelets). In bone marrow toxicity, there will be decreased production of red blood cells (anemia), white blood cells (immunosuppressant), and platelets (easy bleeding).

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