Growth Factors

Question 1

Growth Factors: 3 groups

Answer 1

1) erythropoietic growth factors
- biological name-erythropoietin
2) leukopoietic growth factors
- biological name:
i. granulocyte colony-stimulating factor (G-CSF)
ii. granulocyte macrophage colony-stimulating factor (GM-CSF)
3) thrombopoietic growth factors
- interleukin-11

Question 2

Erythropoietic Growth Factors: medications

Answer 2

1) prototype: epoetin alfa (Epogen, Procrit)
2) Other:
- darbepoetin alfa (Aranesp)–long-acting erythropoietin
- methoxy polyethylene glycol-epoetin beta (Mircera)–very long-acting erythropoietin

Question 3

Purpose of Growth Factors
expected action
therapeutic uses

Answer 3

1) act on bone marrow to increase RBCs
2) -anemia r/t chronic renal failure
- HIV
- chemotherapy
- elective surgery

Question 4

Erythropoietic Growth Factors:
side/adverse effects
nursing interventions/client education

Answer 4

1) hypertension
- due to elevation in Hct levels
2) increased risk of cardiovascular event
- MI, stroke, cardiac arrest

1) monitor BP and Hgb levels
2) decrease dosage levels
3) administer by SQ or IV bolus
4) do not mix medication in a syringe
5) administer doses 3x a week, or once a week

Question 5

Leukopoietic Growth Factors

Answer 5

1) prototype = filgrastim (Neupogen)
2) expected action: stimulates bone marrow to increase production of neutrophils
3) therapeutic use: decreases the risk of infection in clients with neutropenia

Macrophage Colony-Stimulating Factor

1) prototype = sargramostim (Leukine)
2) expected action: increase production (neutrophils, monocytes, macrophages, eosinophils)
3) therapeutic uses: hastens bone marrow production after bone marrow transplant

Question 6

Leukopoietic Growth Factors:
side/adverse effects
nursing interventions/client education

Answer 6

1) -bone pain
- leukocytosis
2) -monitor for bone pain
- give acetaminophen or opioid analgesic
- monitor CBC: notify provider if any of these occur
- give by IV or injection
- do not combine with other medications

Question 7

Granulocyte Macrophage Colony-Stimulating Factor
side/adverse effects
nursing interventions/client education

Answer 7

1) -diarrhea
- weakness
- rash
- malaise
- bone pain
- leukocytosis
- thrombocytosis
2) -monitor for symptoms r/t side/adverse effects, and notify provider if occur
- monitor CBC (2x a wk during treatment)
- may need to reduce the dose
- give by IV infusion

Question 8

Thrombopoietic Growth Factors
expected action
therapeutic uses

Answer 8

1) prototype = oprelvekin (Interleukin-11, Neumega)
2) increases the production of platelets
3) decreases thrombocytopenia and the need for platelet transfusions in clients receiving chemotherapy

Question 9

Thrombopoietic Growth Factors
side/adverse effects
nursing interventions/client education

Answer 9

1) -fluid retention
- cardiac dysrhythmias
- allergic reactions
2) -monitor I&O
- if symptoms of fluid overload occur notify provider
- use cautiously in clients with H/O dysrhythmias
- observe for allergic reactions
- give as a SQ injection