drug therapy for hematopoietic disorders Flashcards
what do hematopoietic growth factors do?
-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
what types of physiologic responses are hematopoietic growth facotrs involved in?
-hematopoiesis, inflammation
-cellular proliferation and differentiation
-wound healing; cellular and humoral immunity
what are hematopoietic cytokines
extrecellular ligands that stimulate hematopoietic cells to differentiate into eight principle types of blood cells
what do hematopoietic cytokines do?
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
what do colony stimulation factors (CSFs) do?
stimulate production of a ton of blood cell shit
-RBCs, platlets
-granulocytes
-neutrophils, basophils, eosinophils
-granulocyte-macrophages
-monocyte-macrophages
-other blood cell types
describe interferons
-inhibit replication of viral and other cells
-activate natural killer cells
describe interleukins
affect immunologic cell response
-stimulatory
-suppresive
where is erthyropoietin secreted from
erythropoietin is a hormone secreted by the kidneys
what does erythropoietin do?
-stimulates red blood cell differentiation, maturation, and proliferation
-increases the amount of RBCs which increases the oxygen carrying capacity of the blood
what conditions may trigger erythropoietin production
-hemorrhage
-anemia
-COPD
-high altitude
what does the immune system do
-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
describe WBCs
-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
name some WBCS
-neutrophils
-eosinophils
-basophils
-monocytes
-lymphocytes
whats included in a CBC
-WBCs
-Hgb/Hct
-RBC
-platelets
what does a CBC with differential measure
meausures everything else as well as the number of each type of WBC
immune function indicates…
host protection from a disease
look at this stem cell shit
what factors may lead to anemia
-erthyropoietin levels low
-deficiency in iron or B12
-genetic predisposition
what are some common signs and symptoms of anemia
-pallor
-SOB
-fatigue
describe iron deficiency anemia
who gets it?
-menstruating women
-pregnancy/lactation
-rapidly gowing adolecents
-GI bleed
less iron = less RBC
describe pernicious anemia
how common is it? causes? tx?
-rare <0.1% og general population
-deficiency of vitamin B12
-tx: IM B12 injections/supplements
describe megaloblastic anemia
what is it? sx? tx?
-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
describe sickle cell anemia
cause? tx?
-genetic
-antimetabolite may help prevent formation of sickle shaped cells
-tx may also include IV fluids and morphine
describe immunostimulants as rx therapy
-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
what do erthryopoiesis stimulating agents do?
induces erthyropoiesis leading to increase hemoglobin and hematocrit levels
what are some examples of erthryopoiesis stimulating agents
-epoetin alpha
-darbepoietin
what are some therpautic actions of erthryopoiesis stimulating agents
-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
describe the pharmacokinetics of erthryopoiesis stimulating agents
-give IV or SQ
-metabolized in serum
-excreted in urine
what are some contraindications of erthryopoiesis stimulating agents
-uncontrolled HTN (dont want to make blood any thicker)
-allergy
-normal renal functioning
what are some nursing implications r/t erthryopoiesis stimulating agents
-monitor CBC for** increase** RBC, Hgb, Hct
-increase energy
-increase tolerance
what is the black box warning for erthryopoiesis stimulating agents
do not use in pt with Hgb of 12 or normal renal function
what do granulocyte colony stimulating factors do?
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)
give an example of granulocyte colony stimulating factors
filgrastim
describe the therapeutic actions of granulocyte colony stimulating factors
stimulates neutrophil progenitor cell production and differentiation in bone marrow =** increase number of mature neutrophils**
describe the pharmacokinetics of granulocyte colony stimulating factors
-administered IV or SQ
-completely absorbed after 4 days
what are some adverse effects of granulocyte colony stimulating factors
-fatigue
-flu like sx
-bone pain
-thrombocytopenia (bleedig gums, ease of bruising)
what are some nursing implications r/t granulocyte colony stimulating factors
-educate on methods to decrease/prevent infection
-report side effects
what are some examples of therapies (both drug and nonpharmacological) to treat iron deficiency anemia
-diet change, increase iron intake
-ferrous aspartate, ferrous gluconate
-ferrous sulfate
-iron dextran
what are some therapeutic actions of drug therapy for iron deficiency anemia
-regain positive iron balance
-treatment of iron deficient anemia
describe the pharmacokinetics of drug therapy for iron deficiency anemia
-IV and PO
-use Z track for IM (iron dextran)
-absorbed in small intestine
what are some contraindications of drug therapy for iron deficiency anemia
-allergy
-hemochromatosis
-hemolytic anemia
-PUD, colitis, enteris
-normal iron balance
what are some adverse effects of drug therapy for iron deficiency anemia
-GI effects
-CNS effects
-others
describe oral administration of drug therapy for iron deficiency anemia
-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)
what are some possible drug-food interactions with drug therapy for iron deficiency anemia
-antacids
-eggs
-milk, coffee, tea
