Anemia Pharm Flashcards
what drug is in the erythropoiesis stimulating agent class
epoetin alfa
MOA of epoetin alfa
mimics human erythropoietin
what does erythropoietin do
stimulates RBC production in the bone marrow
who do you give epoetin alfa to
chronic kidney failure
HIV infection on drug therapy
anemia 2° chemotherapy in certain cancers
pre-operative in patients with anemia
when considering epoetin alfa, what is the hgb you will not give it to
if someone’s hgb is >10 DO NOT GIVE
Nursing considerations for epoetin alfa
weigh the risks versus benefits
- use lowest dose possible to reduce the need to transfuse
- monitor BP before and during therapy
- monitor hgb levels
In a chronic kidney patient what can epoetin alfa cause
increased mortality and serious cardiovascular events
in cancer patients what can epoetin alfa cause
increased mortality and turmor progression
in surgery patients what can epoetin cause
increased thromboembolic events and mortality
what drug is in the iron therapy class
ferrous sulfate
indications for ferrous sulfate
iron deficiency/prevention
moa of ferrous sulfate
taken up by bone marrow cells to make hemoglobin
adverse effects of ferrous sulfate
GI disturbances
teeth staining
tarry stools
Nursing considerations for iron therapy
antacids reduce absorption
food helps prevent GI side effects
food decreases absorption by 50-70%
what drug is a parenteral iron
iron dextran
indications for iron dextran
clear diagnosis of iron deficiency
oral iron is intolerable or ineffective
adverse effects of iron dextran
BLACK BOX: potentially fatal anaphylaxis
safety implications for iron dextran
only use when absolutely necessary
epinephrine and CPR equipment
small “test” dose before each full dose
disadvantages of giving iron dextran IM
persistent pain
discoloration
tumors
risk of anaphylaxis
vitamin b12 drug
cyanocobalamin
indication for cyanocobalamin
B12 deficiency
adverse effects of cyanocobalamin
hypokalemia
why do you have to use caution when taking folic acid and cyanocobalamin
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
Folic acid MOA
converts to the active form of folic acid after administration
indications for folic acid
treatment of folic acid deficiency anemia
prophylaxis of folate deficiency
initial treatment of severe anemia from vitamin b12 deficiency
adverse effects of folic acid
none
