Anemia and hematopoietic agents Flashcards
ferrous sulfate moa
-
ferrous sulfate adverse effects
-GI, NVD, heartburn, bloating, teeth staining, dark green or black stool color
-iron poisoning leading to overdose: NVD and shock, acidosis, gastric necrosis, hepatic failure, pulmonary edema, vasomotor collapse
ferrous sulfate nursing considerations
-interaction of iron with other meds affecting absorption
-co-admin with Vitamin C to increase absorption but watch for increased GI adverse effects
-can use IV or IM if PO doesn’t work/intolerable
-assessment of anemia s/s and diagnostics
ferrous sulfate indications
iron deficiency anemia
also used as prevention
Cyanocobalamin moa
Cyanocobalamin indications
-Vitamin B12/megaloblastic anemia
-impaired absorption
-reduced gastric acid secretion from med use
-lack of intrinsic factor
Cyanocobalamin adverse effects
-generally free from AE
-hypokalemia (muscle weakness, irregular heartbeat) from increased erythrocyte production
Cyanocobalamin nursing considerations
-pt edu on med adherence: lifelong monthly injections
-assess food consumption and improve nutrition
-post admin assessment of anemia s/s and diagnostics
Folic Acid MOA
Folic Acid indications
-folic acid/megaloblastic anemia
-prophylaxis, especially during pregnancy and lactation
-initial tx of severe B12 deficiency and anemia
Folic Acid adverse effects
-generally free from AE
-long term moderate dosing may have slight increase in risk for some cancers (prostate and colorectal)
Folic Acid nursing considerations
-pt edu on med adherence
-assess food and alcohol consumption
promote intake of folate-rich foods and counseling for alcoholism
-part of banana bag (supportive tx for alcohol withdrawal)
Epoetin Alfa MOA
stimulates bone marrow to increase production of RBC
Epoetin Alfa indication
-anemia of CRF
-palliative of chemo-induced anemia of non-myeloid malignancies
-HIV pt with zidovudine
-pre-op for anemic pt prior to elective surgery
Epoetin Alfa adverse effects
-htn related to increase in hematocrit
-increased risk for MI, CVA, and HF
Epoetin Alfa nursing consideration
-dont agitate vial before prepping med
-monitor CV status, CMP, and Fe panel
-monitor CBC, hemoglobin (greater than or equal to 10-11)
-monitor under REMS
Filgrastim MOA
-stimulates bone marrow to increase production of neutrophils
Filgrastim indications
-myelosuppressive chemotherapy
-chemo + BMT of non myeloid origin
-severe chronic neutropenia
Filgrastim adverse effects
-bone pian mild- moderate
-leukocytosis
Filgrastim nursing consideration
-dont agitate vial before prepping
-monitor for pain and utilize appropriate analgesics PRN
monitor CBC and d/c once ANC reaches 10,000
Romiplostim MOA
increases platelet counts by binding to and activating human thrombopoietin receptor
Romiplostim indications
minimizing thrombocytopenia in pt undergoing myelosuppressive radiation and immune thrombocytopenia
Romiplostim adverse effects
-ab pain
-dizziness & headache
-arthralgia
-oropharyngeal pain
-thromboembolism
-progression of existing MDS to AML
Romiplostim nursing consideration
-careful dosage cal needed, syringe with 0.01ml graduations
-monitor CBC, PLT should increase
