Management of Anemia, Thrombocytopenia, and Metabolic Alkalosis

Monitoring and Adjustment of Medications

The American College of Cardiology recommends monitoring CBC every 2-4 weeks until hemoglobin stabilizes above 12 g/dL 1
The patient's platelet count should be monitored weekly until stable above 150 K/uL, as recommended by the American Society of Hematology 2
The National Comprehensive Cancer Network recommends continuing apixaban 2.5 mg twice daily with extreme caution, given thrombocytopenia and atrial fibrillation indication, but monitoring closely for any bleeding signs 3
The American Society of Hematology recommends avoiding NSAIDs and other antiplatelet agents in patients with thrombocytopenia 3
The National Comprehensive Cancer Network recommends considering platelet transfusion only if active bleeding occurs or platelets drop below 50 K/uL 4
The American Heart Association recommends continuing simvastatin 20 mg, as LDL of 116 mg/dL is acceptable given patient's overall clinical picture 1
The American College of Cardiology recommends maintaining current antihypertensive regimen, including metoprolol tartrate 25 mg twice daily and amlodipine 2.5 mg daily 1

The American Society of Hematology recommends monitoring for potential drug-induced cytopenias, including leukopenia/thrombocytopenia, caused by medications such as famotidine, trimethoprim-containing products, and immunosuppressants 1

The American College of Cardiology recommends vigilant monitoring for bleeding risk with concurrent apixaban and thrombocytopenia 3