drug therapy for hematopoietic disorders

Question 1

what do hematopoietic growth factors do?

Answer 1

-regulate the differentiation and proliferation of particular progenitor cells
-growth factors control survival and proliferaion of hematopoietic lineages and also tranduce genuine lineage determining signal inhematopoiesis and initiate cell maturation process

Question 2

what types of physiologic responses are hematopoietic growth facotrs involved in?

Answer 2

-hematopoiesis, inflammation
-cellular proliferation and differentiation
-wound healing; cellular and humoral immunity

Question 3

what are hematopoietic cytokines

Answer 3

extrecellular ligands that stimulate hematopoietic cells to differentiate into eight principle types of blood cells

Question 4

what do hematopoietic cytokines do?

Answer 4

regulate many cellular activities
-act as chemical messengers among cells
-act as growth factors for blood cells

perform binding to receptors on target cells
-trigger alteration of gene expression in target cells

Question 5

what do colony stimulation factors (CSFs) do?

Answer 5

stimulate production of a ton of blood cell shit
-RBCs, platlets
-granulocytes
-neutrophils, basophils, eosinophils
-granulocyte-macrophages
-monocyte-macrophages
-other blood cell types

Question 6

describe interferons

Answer 6

-inhibit replication of viral and other cells
-activate natural killer cells

Question 7

describe interleukins

Answer 7

affect immunologic cell response
-stimulatory
-suppresive

Question 8

where is erthyropoietin secreted from

Answer 8

erythropoietin is a hormone secreted by the kidneys

Question 9

what does erythropoietin do?

Answer 9

-stimulates red blood cell differentiation, maturation, and proliferation
-increases the amount of RBCs which increases the oxygen carrying capacity of the blood

Question 10

what conditions may trigger erythropoietin production

Answer 10

-hemorrhage
-anemia
-COPD
-high altitude

Question 11

what does the immune system do

Answer 11

-detects and eliminates foreign substances that may cause tissue injury or diease
-regulates tissue homeostasis and repair
-immune system cells (WBCs) identify and remove injured, damaged, dead, or malignant cells

Question 12

describe WBCs

Answer 12

-circulate in blood and lymphatic vessels or reside in lymphoid tissues
-ability to circulate and migrate
-major componenet of host defenses
-especially important in phagocytic immune responses

Question 13

name some WBCS

Answer 13

-neutrophils
-eosinophils
-basophils
-monocytes
-lymphocytes

Question 14

whats included in a CBC

Answer 14

-WBCs
-Hgb/Hct
-RBC
-platelets

Question 15

what does a CBC with differential measure

Answer 15

meausures everything else as well as the number of each type of WBC

Question 16

immune function indicates…

Answer 16

host protection from a disease

Question 17

look at this stem cell shit

Answer 17

Question 18

what factors may lead to anemia

Answer 18

-erthyropoietin levels low
-deficiency in iron or B12
-genetic predisposition

Question 19

what are some common signs and symptoms of anemia

Answer 19

-pallor
-SOB
-fatigue

Question 20

describe iron deficiency anemia

who gets it?

Answer 20

-menstruating women
-pregnancy/lactation
-rapidly gowing adolecents
-GI bleed

less iron = less RBC

Question 21

describe pernicious anemia

how common is it? causes? tx?

Answer 21

-rare <0.1% og general population
-deficiency of vitamin B12
-tx: IM B12 injections/supplements

Question 22

describe megaloblastic anemia

what is it? sx? tx?

Answer 22

-larger than normal RBCs/deficient number
-s/sx glossy red tongue/diarrhea
-deficiency of vitamin b12 and or folate
-tx: IM B12 injections / folic acid supplements

Question 23

describe sickle cell anemia

cause? tx?

Answer 23

-genetic
-antimetabolite may help prevent formation of sickle shaped cells
-tx may also include IV fluids and morphine

Question 24

describe immunostimulants as rx therapy

Answer 24

-drugs that stimulate/enhance the immune system by inducing activation or by increaseing any of its components
-used to resotre normal function or to increase the ability of the immune system to eliminate harmful invaders

basically synthetically producing shit we already have, usually given by injection

Question 25

what do erthryopoiesis stimulating agents do?

Answer 25

induces erthyropoiesis leading to increase hemoglobin and hematocrit levels

Question 26

what are some examples of erthryopoiesis stimulating agents

Answer 26

-epoetin alpha
-darbepoietin

Question 27

what are some therpautic actions of erthryopoiesis stimulating agents

Answer 27

-stimulates production of RBCs in bone marrow
-treatment of anemia in renal failure, AIDs, and cancer therapy
-helps avoid blood transfusion necessity

often gien to dialysis pts

Question 28

describe the pharmacokinetics of erthryopoiesis stimulating agents

Answer 28

-give IV or SQ
-metabolized in serum
-excreted in urine

Question 29

what are some contraindications of erthryopoiesis stimulating agents

Answer 29

-uncontrolled HTN (dont want to make blood any thicker)
-allergy
-normal renal functioning

Question 30

what are some nursing implications r/t erthryopoiesis stimulating agents

Answer 30

-monitor CBC for** increase** RBC, Hgb, Hct
-increase energy
-increase tolerance

Question 31

what is the black box warning for erthryopoiesis stimulating agents

Answer 31

do not use in pt with Hgb of 12 or normal renal function

Question 32

what do granulocyte colony stimulating factors do?

Answer 32

stimulates blood cell production by bone marrow in pts with neutropenia (low neutrophil)

neutropenia may be seen in pts with chemotherpay induced febrile neutropenia, acute myeloid leukemia, cancer pts receiving bone marrow transplants, or chronic idiopathic neutropenia)

Question 33

give an example of granulocyte colony stimulating factors

Answer 33

filgrastim

Question 34

describe the therapeutic actions of granulocyte colony stimulating factors

Answer 34

stimulates neutrophil progenitor cell production and differentiation in bone marrow =** increase number of mature neutrophils**

Question 35

describe the pharmacokinetics of granulocyte colony stimulating factors

Answer 35

-administered IV or SQ
-completely absorbed after 4 days

Question 36

what are some adverse effects of granulocyte colony stimulating factors

Answer 36

-fatigue
-flu like sx
-bone pain
-thrombocytopenia (bleedig gums, ease of bruising)

Question 37

what are some nursing implications r/t granulocyte colony stimulating factors

Answer 37

-educate on methods to decrease/prevent infection
-report side effects

Question 38

what are some examples of therapies (both drug and nonpharmacological) to treat iron deficiency anemia

Answer 38

-diet change, increase iron intake
-ferrous aspartate, ferrous gluconate
-ferrous sulfate
-iron dextran

Question 39

what are some therapeutic actions of drug therapy for iron deficiency anemia

Answer 39

-regain positive iron balance
-treatment of iron deficient anemia

Question 40

describe the pharmacokinetics of drug therapy for iron deficiency anemia

Answer 40

-IV and PO
-use Z track for IM (iron dextran)
-absorbed in small intestine

Question 41

what are some contraindications of drug therapy for iron deficiency anemia

Answer 41

-allergy
-hemochromatosis
-hemolytic anemia
-PUD, colitis, enteris
-normal iron balance

Question 42

what are some adverse effects of drug therapy for iron deficiency anemia

Answer 42

-GI effects
-CNS effects
-others

Question 43

describe oral administration of drug therapy for iron deficiency anemia

Answer 43

-administer between meals if possible (increases absorption)
-use straw if liquid (stains teeth)
-monitor GI activity (very constipating med, may need stool softeners given with it)

Question 44

what are some possible drug-food interactions with drug therapy for iron deficiency anemia

Answer 44

-antacids
-eggs
-milk, coffee, tea