Ch 56 Hematopoietic Agents

Question 1

Epoetin is given to increase __.

Answer 1

red blood cell counts and thereby decrease the need for transfusions.

Specific indications include anemia associated with (1) chronic renal failure, (2) myelosuppressive cancer chemotherapy, and (3) zidovudine therapy in patients with HIV/AIDS.

Question 2

By increasing the hematocrit, epoetin can cause or exacerbate __..

Answer 2

hypertension

Question 3

Epoetin increases the risk of __.

Answer 3

cardiovascular events (e.g., cardiac arrest, stroke, HF, MI),

especially when the hemoglobin level exceeds 11 gm/dL or the rate of rise in hemoglobin exceeds 1 gm/dL in 2 weeks.

Question 4

In some cancer patients, epoetin can accelerate __.

Answer 4

tumor progression and shorten life

Question 5

Owing to the risk of serious toxicity, __ must be
prescribed and used under a new Risk Evaluation and
Mitigation Strategy (REMS).

Answer 5

epoetin

Question 6

Filgrastim is given to elevate __.

Answer 6

neutrophil counts and thereby reduce the risk of infection.

Specific indications are chronic severe neutropenia and neutropenia associated with cancer chemotherapy or BMT.

Question 7

The principal adverse effects of filgrastim are (2).

Answer 7

bone pain and leukocytosis

Question 8

__ is used to accelerate recovery from BMT, treat patients in whom a bone marrow transplant has failed, and accelerate neutrophil recovery in patients undergoing chemotherapy for AML.

Answer 8

Sargramostim

Question 9

The principal adverse effect of sargramostim is __.

Answer 9

leukocytosis

Question 10

__ is given to stimulate platelet production in patients undergoing myelosuppressive chemotherapy for nonmyeloid cancers.

Answer 10

Oprelvekin

The goal is to minimize thrombocytopenia and platelet transfusions.

Question 11

The principal adverse effects of oprelvekin are __.

Answer 11

fluid retention (which causes edema and anemia), 
cardiac dysrhythmias (tachycardia, atrial fibrillation, and atrial flutter), and 
severe allergic reactions, including anaphylaxis.

Question 12

__ are used to increase platelet production in patients

with ITP after traditional methods of treatment have failed.

Answer 12

TRAs

Question 13

Uncommon but serious effects of TRAs include (3).

Answer 13

bone marrow fibrosis, hematologic malignancy, and thrombotic/thromboembolic complications.

Question 14

Since (4) stimulate proliferation of bone marrow cells, these drugs should be used with great caution, if at all, in patients with cancers of bone marrow origin.

Answer 14

epoetin alfa, filgrastim, sargramostim, and oprelvekin