Anemia and Hematopoietic Agents Flashcards
ANEMIA ◦Oral Iron a. ferrous sulfate (Feosol®) b. iron dextran (INFed®) c. Folic Acid and Cyanocobalamin
a. ferrous sulfate (Feosol®)
ANEMIA ◦ Parenteral Iron a. ferrous sulfate (Feosol®) b. iron dextran (INFed®) c. Folic Acid and Cyanocobalamin
b. iron dextran (INFed®)
ANEMIA ◦ B Vitamins a. ferrous sulfate (Feosol®) b. iron dextran (INFed®) c. Folic Acid and Cyanocobalamin
c. Folic Acid and Cyanocobalamin
▪ Iron replenishment for the body when dietary is
insufficient (or excessive loss has occurred)
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
a. ferrous sulfate (Feosol®)
Adverse liquid iron can STAIN teeth a. ferrous sulfate (Feosol®) b. iron dextran (INFed®) c. Folic Acid and Cyanocobalamin
a. ferrous sulfate (Feosol®)
Adverse black stool normal (not a bleed!) a. ferrous sulfate (Feosol®) b. iron dextran (INFed®) c. Folic Acid and Cyanocobalamin
a. ferrous sulfate (Feosol®)
avoid administering with oral antibiotics (fluoroquinolones and tetracyclines) a. ferrous sulfate (Feosol®) b. iron dextran (INFed®) c. Folic Acid and Cyanocobalamin
a. ferrous sulfate (Feosol®)
Avoid caffeine + dairy
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
a. ferrous sulfate (Feosol®)
Overdose: ANTIDOTE: deferoxamine (Desferal ®)
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
a. ferrous sulfate (Feosol®)
▪leading cause of poisonings in children
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
a. ferrous sulfate (Feosol®)
Give on empty stomach for best absorption
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
a. ferrous sulfate (Feosol®)
BOXED WARNING: anaphylactic reactions during any dose ?
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
b. iron dextran (INFed®)
IRON DANGEROUS
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
b. iron dextran (INFed®)
Use Z-track technique
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
b. iron dextran (INFed®)
▪ Hypotension: Check vitals frequently
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
b. iron dextran (INFed®)
BOXED WARNING: risk for anaphylaxis
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
b. iron dextran (INFed®)
Water-soluble, B-complex vitamin (B9
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
Folic Acid
Deficiency resulting in Macrocytic Anemia
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
Folic Acid
◦ During pregnancy to prevent neural tube defects
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
Folic Acid
Malabsorption syndromes
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
Folic Acid
◦ May mask symptoms of pernicious anemia
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
Folic Acid
- Chronic Alcohol use
a. ferrous sulfate (Feosol®)
b. iron dextran (INFed®)
c. Folic Acid and Cyanocobalamin
Folic Acid
Used to treat pernicious anemia
c. Folic Acid and Cyanocobalamin
Cyanocobalamin
Intranasal: Administer 1 hour before or 1 hour after ingestion of hot foods/liquids.
c. Folic Acid and Cyanocobalamin
d. Epoetin alfa, Darbepoetin
alfa
Cyanocobalamin
USED TO TREAT- ◦ Anemia in CKD c. Folic Acid and Cyanocobalamin d. Epoetin alfa, Darbepoetin alfa
d. Epoetin alfa, Darbepoetin
alfa
USED TO TREAT- ◦ Chemotherapy induced Anemia (requires REMS) c. Folic Acid and Cyanocobalamin d. Epoetin alfa, Darbepoetin alfa
d. Epoetin alfa, Darbepoetin
alfa
Goal is to increase the Hemoglobin and Hematrocit (H/H) so patient is no longer Anemic
c. Folic Acid and Cyanocobalamin
d. Epoetin alfa, Darbepoetin
alfa
d. Epoetin alfa, Darbepoetin
alfa
◦ Milk Shake Analogy
c. Folic Acid and Cyanocobalamin
d. Epoetin alfa, Darbepoetin
alfa
d. Epoetin alfa, Darbepoetin
alfa
CONTRA-INDICATIONS ◦ Drug allergy, uncontrolled hypertension, head and neck cancers, risk of thrombosis c. Folic Acid and Cyanocobalamin d. Epoetin alfa, Darbepoetin alfa
d. Epoetin alfa, Darbepoetin
alfa
BOXED WARNING CANCER, CHRONIC KIDNEY DISEASE:,CARDIOVASCULAR: c. Folic Acid and Cyanocobalamin d. Epoetin alfa, Darbepoetin alfa
d. Epoetin alfa, Darbepoetin
alfa
BEFORE ADMINISTRATION: Monitor blood pressure (risk for stroke, MI) Monitor hemoglobin and hematocrit (H/H c. Folic Acid and Cyanocobalamin d. Epoetin alfa, Darbepoetin alfa
d. Epoetin alfa, Darbepoetin
alfa
ADMINISTRATION Single Use Vial, One time use, don’t use vial for multiple doses Do NOT shake/agitate c. Folic Acid and Cyanocobalamin d. Epoetin alfa, Darbepoetin alfa e. Fil –gra-stim
d. Epoetin alfa, Darbepoetin
alfa
USED TO TREAT- ◦ Chemotherapy induced Neutropenia d. Epoetin alfa, Darbepoetin alfa e. Fil –gra-stim
e. Fil –gra-stim
ADVERSE EFFECTS- ◦ Bone pain (25% of patients) ◦ Leukocytosis d. Epoetin alfa, Darbepoetin alfa e. Fil –gra-stim
e. Fil –gra-stim
BEFORE ADMINISTRATION: Monitor CBC twice weekly (WBC/ANC) HOLD IF WBC >10,000, ANC >1,500 d. Epoetin alfa, Darbepoetin alfa e. Fil –gra-stim
e. Fil –gra-stim
e. Fil –gra-stim
Monitor ? twice weekly (?)
CBC
WBC/ANC
e. Fil –gra-stim
HOLD IF WBC ?,
ANC ?
> 10,000
>1,500