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Anemia, Hematopoietic Flashcards

1
Q

ANEMIA?

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate (Feosol®)

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2
Q

Parenteral Iron?

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Iron dextran (INFed®)

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3
Q

B Vitamins?

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Folic Acid and Cyanocobalamin

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4
Q

ESA- Erythropoietin Stimulating Agent?

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A 
Epoetin alfa (Epogen®)
Darbepoetin alfa
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5
Q

G-CSF- Granulocyte Colony Stimulating Factor?

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®)

Sargramostim

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6
Q

Which deals with Anemias

Bone Marrow
Nausea
Erythropoietin
Vomiting
Iron, folic acid, B12
Diarrhia
Cyanocobalamin
A

Bone Marrow
Erythropoietin
Iron, folic acid, B12
Cyanocobalamin

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7
Q

Building blocks for erythrocytes?

Bone Marrow
Iron, folic acid, B12(cyanocobalamin)
Erythropoietin

A

Iron, folic acid, B12(cyanocobalamin)

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8
Q

Synthesis of erythrocytes

Bone Marrow
Iron, folic acid, B12(cyanocobalamin)
Erythropoietin

A

Bone Marrow

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9
Q

Stimulates bone marrow

Bone Marrow
Iron, folic acid, B12(cyanocobalamin)
Erythropoietin

A

Erythropoietin

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10
Q

What happens if the following are low?
Bone Marrow
Iron, folic acid, B12(cyanocobalamin)
Erythropoietin

A

Anemia will result

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11
Q

USED TO TREAT
Iron deficiency anemia
Prevention
Treatment

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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12
Q

MECHANISM OF ACTION:Iron replenishment for the body when dietary is insufficient (or excessive loss has occurred)

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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13
Q

ADVERSE EFFECTS- ◦
GI TRACT◦
nausea, heartburn, bloating, constipation

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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14
Q

Liquid can STAIN teeth?

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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15
Q

Both forms can “stain” a bowel movement- black stool normal?

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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16
Q

Which of the following you should do with Oral Iron Products: Ferrous Sulfate?

Rinse mouth!
Dilute with water or juice
Dilute with Alcohol
Drink with a Straw
Drink with a cup.
A

Rinse mouth!
Dilute with water or juice
Drink with a Straw

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17
Q

Game plan: Take on an empty stomach for BEST absorption?

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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18
Q

GI UPSET- then take with food (last case resort)

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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19
Q

ABSORPTION:
Increase: Vitamin C/ ascorbic acid

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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20
Q

ABSORPTION:
Decrease: Caffeine/Tea/Dairy (calcium)

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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21
Q

Iron has
Does DRUG-DRUG interaction or
Doesn’t have DRUG-DRUG Interaction

A

Does DRUG-DRUG interaction

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22
Q

Avoid administering with oral antibiotics (fluoroquinolones and tetracyclines)

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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23
Q

Avoid caffeine + dairy

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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24
Q

Severe N/V/D, shock, liver/heart failure

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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25
Q

Most common cause of pediatric poisoning deaths

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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26
Q

Children can appear asymptomatic

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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27
Q

Overdose: ANTIDOTE: deferoxamine (Desferal ®)

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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28
Q

Warn about toxicity in children!!!

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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29
Q

Avoid co-administration with certain drugs/foods

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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30
Q

Liquid is commonly given through a straw or with Orange/Tomato juice to help absorption

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Ferrous sulfate- Oral Iron Products:

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31
Q

Treatment of iron deficiency anemia

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Parenteral Iron Products: Iron dextran

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32
Q

BOXED WARNING: anaphylactic reactions during any dose!

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Parenteral Iron Products: Iron dextran

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33
Q

only ? product requiring a small TEST dose first only?

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Parenteral Iron Products: Iron dextran

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34
Q

Hypotension during administration- Monitor vitals

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Parenteral Iron Products: Iron dextran

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35
Q

Not commonly done anymore but.
◦IM Route- Use Z-track technique

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Parenteral Iron Products: Iron dextran

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36
Q

Use Z-track technique

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Parenteral Iron Products: Iron dextran

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37
Q

Iron replenishment for the body when dietary is insufficient (or excessive loss has occurred)

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Parenteral Iron Products: Iron dextran

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38
Q

Low hemoglobin and hematocrit

MIcrocytic anemia (small MCV)
Macrocytic anemias (large MCV)
Normocytic Anemia
A

Normocytic Anemia

39
Q

Iron replenishment for the body when dietary is insufficient (or excessive loss has occurred)

Folic Acid and Cyanocobalamin
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Parenteral Iron Products: Iron dextran

40
Q

Megaloblastic anemias (DNA issue) most common

MIcrocytic anemia (small MCV)
Macrocytic anemias (large MCV)
Normocytic Anemia
A

Macrocytic anemias (large MCV)

41
Q

Vitamin B12 deficiency, folate deficiency

MIcrocytic anemia (small MCV)
Macrocytic anemias (large MCV)
Normocytic Anemia
A

Macrocytic anemias (large MCV)

42
Q

Large MCV◦
Folate Deficiency, Pernicious Anemia

Treatment

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Folic Acid (B9) and Cyanocobalamin (B12)

43
Q

B9 =

Cyanocobalamin
Folic Acid

A

Folic Acid

44
Q

B12=

Cyanocobalamin
Folic Acid

A

Cyanocobalamin

45
Q

Folic acid deficiency resulting in Macrocytic Anemia

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Folic Acid (B9)

46
Q

During pregnancy to prevent neural tube defects

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Folic Acid (B9)

47
Q

Folic acid deficiency resulting in Macrocytic Anemia

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Folic Acid (B9) B Vitamins

48
Q

During pregnancy to prevent neural tube defects

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Folic Acid (B9) B Vitamins

49
Q

used for Chronic Alcohol, Methotrexate

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Folic Acid (B9) B Vitamins

50
Q

Should not be used until actual cause of anemia is determined?

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Folic Acid (B9) B Vitamins

51
Q

May mask symptoms of pernicious anemia?

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Folic Acid (B9) B Vitamins

52
Q

Seizure meds often decrease ? levels

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Folic Acid (B9) B Vitamins

53
Q

Used to treat pernicious anemia and other megaloblastic anemias

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Cyanocobalamin (B12) B Vitamins

54
Q

Requires Intrinsic Factor for absorption

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Cyanocobalamin (B12) B Vitamins

55
Q

Can be given IM, SC, orally, intranasallyLow risk for toxicity

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Cyanocobalamin (B12) B Vitamins

56
Q

Low risk for toxicity

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Cyanocobalamin (B12) B Vitamins

57
Q

Often times, patients cannot absorb via GI Tract. Common to see INJECTIONS (IM,SC) or even Intranasal

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Cyanocobalamin (B12) B Vitamins

58
Q

White blood cell lineage-

Granulocyte colony stimulating factor (G-CSF)
Erythropoietin

A

Granulocyte colony stimulating factor (G-CSF)

59
Q

Red blood cell lineage-

Granulocyte colony stimulating factor (G-CSF)
Erythropoietin

A

Erythropoietin

60
Q

Release erythropoietin to stimulate RBCs in Bone Marrow

Liver or Kidneys

61
Q

Insufficient oxygen

Liver or Kidneys

62
Q

Anemia in CKD- Chronic kidney disease

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

63
Q

Chemotherapy induced Anemia (requires REMS)

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

64
Q

Goal is to increase the Hemoglobin and Hematrocit (H/H)

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

65
Q

You should observe an H/H increase

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

66
Q

Erythropoietin Stimulating Agents (ESA’s): Epoetin alfa, Darbepoetin alfa

The goal cut off is Hgb of ? gm/dL◦Higher than this increases risk of adverse effects

67
Q

HYPERTENSION (most common)◦Heart Attack, Stroke, Heart Failure, thrombosis, seizure

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

68
Q

Blood Clots (DVTs/PEs)

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

69
Q

Went from low H/H (“thin blood”) to increased H/H (“thickened the blood”)

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

70
Q

Contraindications: drug allergy, uncontrolled hypertension, head and neck cancers, risk of thrombosis

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

71
Q

BOXED WARNING: ESA’s: Epoetin Alfa

DIABITIES
CANCER
CHRONIC KIDNEY DISEASE
SJS
CARDIOVASCULAR
SULFUR
A

CANCER
CHRONIC KIDNEY DISEASE
CARDIOVASCULAR

72
Q

Boxed Warning
CANCER
CHRONIC KIDNEY DISEASE
CARDIOVASCULAR

A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

73
Q

Monitor blood pressure PRIOR TO ADMINISTRATION and frequently (risk for stroke, MI)

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

74
Q

Monitor hemoglobin levels (>11 g/dL) PRIOR TO ADMINISTATION (increases risk for thrombotic event and BP event)

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

75
Q

Patients should report body aches, headaches

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

76
Q

ADMINISTRATION: Single Use Vial

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

77
Q

Do NOT shake/agitate

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

78
Q

One time use, don’t use vial for multiple doses

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

79
Q

IV (Dialysis)
SC (on the Unit)

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

80
Q

Stimulates production of RBC’s in the bone marrow. Natural hormone is produced by the kidneys

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

81
Q

Do not give if active tumor (head/neck) can cause tumor progression

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Epoetin alfa, Darbepoetin alfa: Erythropoietin Stimulating Agents (ESA’s)

82
Q

Severe Chronic Neutropenia

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®) - G-CSF’s

83
Q

Chemotherapy induced Neutropenia

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®) - G-CSF’s

84
Q

Many other uses pertaining to stem cells/bone marrow transplants

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®) - G-CSF’s

85
Q 
ADVERSE EFFECTS- 
Bone pain (25% of patients)

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®) - G-CSF’s

86
Q

Leukocytosis- excessive production- very rare, but this controlled by monitoring CBC’s frequently

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®) - G-CSF’s

87
Q

Monitor CBC twice weekly (WBC/ANC)

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®) - G-CSF’s

88
Q

CSF: Filgrastim

HOLD IF WBC > ? , ANC > ?

A

10,000

1,500

89
Q

Patients should report body aches (bone pain), can treat pain if needed (acetaminophen or opioids)

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®) - G-CSF’s

90
Q

IM/SC- DO NOT SHAKE VIALS! Discard after one usage- Not reusable

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®) - G-CSF’s

91
Q

Essentially identical to human granulocyte colony-stimulating factor

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®) - G-CSF’s

92
Q

Ad SE
Bone pain

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®) - G-CSF’s

93
Q

Leukocytosis

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®) - G-CSF’s

94
Q

splenomegaly

Folic Acid (B9) 
Cyanocobalamin (B12)
Epoetin alfa (Epogen®)
Darbepoetin alfa
Iron dextran (INFed®)
Ferrous sulfate 
Filgrastim (Neupogen®)
Sargramostim
A

Filgrastim (Neupogen®) - G-CSF’s

Phamacology (13 decks)

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