anemia meds Flashcards
what kind of anemia is iron deficiency anemia?
microcytic hypochromic
prefferred tx for iron deficiency anemia
ferrous sulfae 325 mg PO TID
when to recheck hgb after tx for iron deficiency anemia
2-3 weeks
ferrous sulfate admin
take with food vitamin C increases absorption do not take w other meds can stain teeth keep away from children - toxicity
who is recommended prophylactic iron?
pregnant women
excessive menstrual blood loss
infants
adults with chronic blood loss
iron AEs
iron can deposit in soft tissue - hemochromatosis
constipation, black stools, GI upset, anaphylaxis, HTN
precautions for iron dosing
GI disease, ETOH, renal disease, liver impairment, hypersensitivity
iron drug interactions
antacids, quinolones, tetracyclines
generally take 2 hrs apart from other meds
hemochromatosis tx
iron chelators - deferoxamine, deferiprone
Ganzoni’s formula
calculate iron replacement
weight in kg * (target hgb-actual hgb) * 2.4 + depot iron
types of megaloblastic anemia
folate deficiency
vitamin B12 deficiency (pernicious anemia)
large MCV
indications for folic acid therapy
anemia
pregnancy prophylaxis
vascular disease
some ETOH dependence, dialysis, liver disease, hemolytic anemia
folic acid dosing for pregnancy
.4 mg daily
folic acid dosing for anemia
1 mg daily
hgb will increase in 1-2 weeks
contraindication to folic acid
B12 deficiency
folic acid AE
nausea, bad taste
other name for B12
cobalamin/cyanocobalamin
cause of B12 deficiency
elderly loss of intrinsic factor – poor absorption
veganism
B12 dosing
100-1000 mcg IM QD or Q2D
PO for prophylaxis
B12 AEs
injection site pain, GI, HA, hypersensitivity, hypoK
indications for erythropoietin stimulating agents
chemotherapy-induced anemia
chronic renal disease anemia
anticipated EBL >500 for surgery
target hgb 10-12
must be given with iron
ESAs
epoetin
darbepoetin
ESAs BBWs
renal disease -cardiovascular events w hgb >10
cancer - decreased survival - use lowest dose to keep hgb 10
avoid aggressive dosing!
ESAs AEs
arthralgias, HA
HTN, CHF, thrombosis, seizures
colony stimilulating factors
filgrastin
sargramostim
filgrastim dosing
5mcg/kg SC or IV daily beginning day after chemo
preferred!!
sargramostim dosing
250 mcg/m2 SC daily beginning day after chemo
more AEs than filgrastim
colony-stimulating factors AE
bone pain, fever/chillls, rash, splenic rupture
colony stimulating factor precautions
E coli, yeast allergy
resp distress, dyspnea, fluid retention
oprelvekin MOA
simulates production of platelets and neutrophils
generally given to prevent thrombocytopenia
oprelvekin AEs
CV side effects, fatigue, HA, dizziness
thrombopoietin agonists
romiplostim
eltrombopag
similar limitations to oprelvekin
