Anemia Pharm

Question 1

what drug is in the erythropoiesis stimulating agent class

Answer 1

epoetin alfa

Question 2

MOA of epoetin alfa

Answer 2

mimics human erythropoietin

Question 3

what does erythropoietin do

Answer 3

stimulates RBC production in the bone marrow

Question 4

who do you give epoetin alfa to

Answer 4

chronic kidney failure
HIV infection on drug therapy
anemia 2° chemotherapy in certain cancers
pre-operative in patients with anemia

Question 5

when considering epoetin alfa, what is the hgb you will not give it to

Answer 5

if someone’s hgb is >10 DO NOT GIVE

Question 6

Nursing considerations for epoetin alfa

Answer 6

weigh the risks versus benefits

• use lowest dose possible to reduce the need to transfuse
• monitor BP before and during therapy
• monitor hgb levels

Question 7

In a chronic kidney patient what can epoetin alfa cause

Answer 7

increased mortality and serious cardiovascular events

Question 8

in cancer patients what can epoetin alfa cause

Answer 8

increased mortality and turmor progression

Question 9

in surgery patients what can epoetin cause

Answer 9

increased thromboembolic events and mortality

Question 10

what drug is in the iron therapy class

Answer 10

ferrous sulfate

Question 11

indications for ferrous sulfate

Answer 11

iron deficiency/prevention

Question 12

moa of ferrous sulfate

Answer 12

taken up by bone marrow cells to make hemoglobin

Question 13

adverse effects of ferrous sulfate

Answer 13

GI disturbances
teeth staining
tarry stools

Question 14

Nursing considerations for iron therapy

Answer 14

antacids reduce absorption
food helps prevent GI side effects
food decreases absorption by 50-70%

Question 15

what drug is a parenteral iron

Answer 15

iron dextran

Question 16

indications for iron dextran

Answer 16

clear diagnosis of iron deficiency

oral iron is intolerable or ineffective

Question 17

adverse effects of iron dextran

Answer 17

BLACK BOX: potentially fatal anaphylaxis

Question 18

safety implications for iron dextran

Answer 18

only use when absolutely necessary
epinephrine and CPR equipment
small “test” dose before each full dose

Question 19

disadvantages of giving iron dextran IM

Answer 19

persistent pain
discoloration
tumors
risk of anaphylaxis

Question 20

vitamin b12 drug

Answer 20

cyanocobalamin

Question 21

indication for cyanocobalamin

Answer 21

B12 deficiency

Question 22

adverse effects of cyanocobalamin

Answer 22

hypokalemia

Question 23

why do you have to use caution when taking folic acid and cyanocobalamin

Answer 23

b/c folic acid can fix anemia but we are masking B12 deficiency still exsits, hurting neurologic system
WHEN TAKING BOTH make sure patient is on high enough dose of b12

Question 24

Folic acid MOA

Answer 24

converts to the active form of folic acid after administration

Question 25

indications for folic acid

Answer 25

treatment of folic acid deficiency anemia
prophylaxis of folate deficiency
initial treatment of severe anemia from vitamin b12 deficiency

Question 26

adverse effects of folic acid

Answer 26

none