Thrombocytopenia and Leucopenia Following Carbutamide

Gastrointestinal Bleeding During Tolbutamide Therapy

“…The most likely causes suggested are (1) increased gastric secretion, leading to peptic erosion and ultimate bleeding; (2) a local factor consisting of injury to the mucus-producing cells or blood vessels of the gastric or duodenal mucosa, resulting in diminished tissue resistance; (3) a liypersensitivity reaction, with damage to the capil-laries of the mucosa; (4) a humoral factor; and finally (5) an effect on the hematopoietic system, causing either increased capillary fragility or thrombopenia and thus interfering with the normal clotting mechanism.4 In many instances a drug can produce bleeding in more than one way. Some be¬ lieve that each drug behaves in its own character¬ istic manner according to the so-called drug species reactivity.…”