final lecture 2 Flashcards
filgrastim name brand
neupogen
filgrastim
G-CSF 5mcg.kg.day until ANC>10,000
pegfilgrastim name brand
neulasta
pegfilgrastim
G-CSF 6mg once
Sargramostim name brand
leukine
sargramostim
GM-CSF 250 mcg/m^2/day until ANC>1500
high risk pts who may benefit from CSFs in neutropenia
neutropenia >10 days
ANC65
infectious complications
pts hospitalized at time of neutropenic fever
ITP has ___ correlation with platelet count
lack of
when to treat ITP
when pt is symptomatic
plts<30,000
consider when plts 30,000-50,000 & HTN, older age, or risk of trauma
goal of ITP treatment
safe plt count, not normal plt count
first line ITP management
corticosteroids
IVIG
anti-D
* only w/ intact spleen
second line ITP management
splectomy, rituximab, romiplostim, eltrombopag
corticosteroids in ITP
prednisone, dexamethasone, HD methylprednisolone
IVIG doses in ITP
children: 0.8-1g/kg single infusion
adults: 1g/kg/day for 2 days
IVIG MOA
block Fc receptor on macrophages; competitive inhibition of autoantibody
IVIG black box warning
nephrotoxicity
anti-Rh(D) in ITP
may delay/remove need for splenectomy
used in Rh+ pts only
50-75mcg/kg infused once over 5-10 min
anti-Rh(D) MOA
binds to erythrocyte D antigen-> immune mediated clearance of erythrocytes; Fc
anti-Rh(D) can cause
hemolysis
immunizations needed before splenectomy
2 wees prior to surgery
H. influenzae B, meningococcal, pneumococcal
rituximab brand name
rituxan
rituximab
anti-CD20; inhibits autoantibody production
TPO mimetics
romiplostim, eltrobopag
temp maintenance therapy
romiplostim brand name
NPlate
Eltrombopag brand name
Promacta
romiplostim
1mcg/kg SQ once/wk
plts>50,000
monitor weekly CBC
etrombopag
50mg PO qd
plts>50,000
etrombopag black box warning
hepatotoxicity
