Agents for Megaloblastic Anemias

Question 1

Agents for Megaloblastic Anemias: Names

Answer 1

◦Folic acid

B12:
◦Hydroxocobalamin, injectable drug
◦Cyanocobalamin, nasal spray

Question 2

Agents for Megaloblastic Anemias: Actions

Answer 2

◦Essential for cell growth and division for the production of a strong stroma in RBCs
◦B12 is also necessary for the maintenance of the myelin sheath in nerve tissues

Question 3

Agents for Megaloblastic Anemias: Indications

Answer 3

◦Replacement therapy for dietary deficiencies, pregnancy

◦Folic acid is used as a rescue drug for cells exposed to some toxic chemotherapeutic agents

Question 4

Agents for Megaloblastic Anemias: Contraindications and Cautions

Answer 4

Contraindications:
◦Allergy

Caution:
◦Pregnancy or lactation
◦Patients with other anemias

Question 5

Agents for Megaloblastic Anemias: Adverse Effects

Answer 5

◦Pain and discomfort at the injection site

◦Nasal irritation with intranasal spray

Question 6

Agents for Megaloblastic Anemias: Drug Interactions

Answer 6

◦Relatively few since they are essential

Question 7

Agents for Megaloblastic Anemias: Assessment

Answer 7

◦History and physical exam and known allergy
◦Pregnancy, lactation, and nasal erosion
◦Affect, orientation, and reflexes; pulse, blood pressure, and perfusion; respirations and adventitious sounds
◦Complete blood count, hematocrit, and iron levels

Question 8

Agents for Megaloblastic Anemias: Nursing Diagnosis

Answer 8

◦Acute pain related to injection or nasal irritation
◦Risk for fluid volume imbalance related to CV effects
◦Deficient knowledge regarding drug therapy

Question 9

Agents for Megaloblastic Anemias: Implementation

Answer 9

◦Confirm the nature of the megaloblastic anemia
◦Give both types of drugs in cases of pernicious anemia
◦Parenteral vitamin B12 must be given IM each day for 5 to 10 days and then once a month for life
◦Arrange for nutritional consultation
◦Monitor for the possibility of hypersensitivity reactions
◦Arrange for hematocrit readings before and periodically during therapy
◦Provide thorough patient teaching

Question 10

Agents for Megaloblastic Anemias: Evaluation

Answer 10

◦Monitor patient response to the drug (alleviation of anemia)
◦Monitor for adverse effects (nasal irritation, pain at injection site, nausea)
◦Evaluate the effectiveness of the teaching plan
◦Monitor the compliance with the regimen