12. Hematopoietics Flashcards
hematopoietics
recombinant growth factors
erythropoetin stimulation agent - increase RBC production (epoetin)
granulocyte stimulating agents - increase myeoblast cells (G-CSF, GM-CSF)
platelet stimulating agent - increase platelet production - thrombocytes
ESAs
eopetin, procrit, darbepoetin
given IV or subQ
uses: anemia from renal disease, chemotherapy, HIV/AIDS, reduce blood transfusions from surgery, endurance athletes
onset of action: 2-6 weeks
darbepoetin is dosed weekly
monitoring: hemoglobin, iron levels
G-CSF
filgrastim, pegfilgrastim
IV, SubQ
Uses: treatment of neutroprnic complications in cancer patients, nonmyeloid malignancies , HIV patients and Hep C
Onset: 2-3 days
pegfilgrastim needs to be given once, filgrastim once daily
monitoring: absolute nuetrophil count (ANC)
work faster then ESAs, increase stem cells after chemotherapy
GM-CSF
sargramostim
Uses: acute myelogenous luekemia, bone marrow transplant, radiation-induced bone marrow suppression
onset: 5-7 days
monitoring: CBC with differential
TPO receptors
romiplostim, eltrombopag
MOA: binds to and activates human thrombopoietin receptor
onset: increased platelet production in a week
uses: chronic immune thrombocytopenia
clot formation
due to increased venous stasis - slow blood flow vascular endothelium damage medications hormones cancer genetic disorders
Virchow’s triad
stasis
vessel wall injury
hypercoagulability
perfect storm for thrombosis - blood clot
normal body response
platelet activation
formation of the platelet plug
reinforcement of platelet plug with fibrin
dissolve clot once vascular damage is repaired
extrinsic Intrinsic clotting cascade
intrinsic contact system: begins with tissue factor
merge at factor 10a -
10a activates thrombin (2a) enhance formation of fibrinogen and platelets
fibrinogen causes cellular cross clinking of fibrin and stabilization of clot
arterial clots
happen on left side of heart and above
platelet rich
venous clots
RBC and fibrin
DVT pulmonary embolism
