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320 Pharmacology > Hematology: Anemia Drugs > Flashcards

Hematology: Anemia Drugs Flashcards

1
Q

What is the primary function of bones? List the types of blood cells.

A
  • Formation of new blood cells
    ~ Red blood cells (RBCs)
    » Erythropoiesis
    ~ White blood cells (WBCs)
    ~ Platelets
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2
Q

Describe RBCs.

A
  • Manufactured in bone marrow
  • More than one third of a RBC is made of hemoglobin
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3
Q

Describe anemia.

A
  • Excessive destruction of RBCs (hemolytic anemias)
  • Underlying causes of anemia are red blood cell (RBC) maturation defects and factors secondary to excessive RBC destruction
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4
Q

List an example of an Erythropoiesis-Stimulating Agent (ESAs).

A

Epoetin alfa

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5
Q

Epoetin alfa drug profile?

A
  • Biosynthetic form of the natural hormone erythropoietin
  • Most patients receiving epoetin alfa need to also receive an oral or intravenous (IV) iron preparation
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6
Q

Epoetin alfa indication?

A

Therapeutic goal is to elevate RBCs which would decrease the need for blood transfusions

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7
Q

Epoetin alfa contraindication?

A
  • patients w/ uncontrolled HTN
  • hemoglobin levels above 10 g/dL for cancer patients
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8
Q

Epoetin alfa adverse effects?

A

CV: HTN
MSK: arthralgia
DERM: pruritus, transient rash
MISC: fever, headache, and injection site reaction

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9
Q

Epoetin alfa drug interactions?

A

May increase requirement for heparin during hemodialysis (for those w/ ESRD)

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10
Q

Epoetin alfa nursing considerations?

A
  • Monitor BP before and during therapy; notify HCP if severe HTN is present or if BP starts to increase
  • Monitor for symptoms of anemia
  • Monitor CBC; may cause an increase in WBCs and platelets
  • Monitor serum ferritin and iron levels to assess the need for concurrent therapy
  • Implement seizure precautions if needed
  • DO NOT shake the vial; inactivation of the medication may occur
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11
Q

Epoetin alfa patient education?

A
  • Notify HCP immediately of cues of blood clots
  • For women, discuss the possible return of menses
  • For CKD patients, stress the importance of compliance w/ dietary restrictions (high iron and low potassium)
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12
Q

Describe iron.

A
  • Oxygen carrier
  • Stored in the liver, spleen, and bone marrow
  • Iron deficiency results in anemia
  • Dietary iron must be converted by gastric juices before it can be absorbed
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13
Q

How is iron adminstered?

A

Oral & Parenteral

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14
Q

List the types of Oral Iron.

A
  • Oral iron preparations are available as ferrous salts
    ~ Ferrous fumarate
    ~ Ferrous sulfate
    ~ Ferrous gluconate
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15
Q

List the types of Parenteral Iron.

A
  • Parenteral
    ~ Iron dextran
    ~ Iron sucrose
    ~ Ferric gluconate
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16
Q

Iron indication?

A
  • Prevention and treatment of iron-deficiency syndromes
  • Alleviates the symptoms of iron-deficiency anemia
17
Q

Iron contraindications?

A
  • Anemia not d/t iron deficiency
  • Hemochromatosis
  • Hypersensitivity to iron products
  • Take cautiously in: alcoholism, severe renal impairment, severe hepatic impairment
18
Q

Iron adverse effects?

A
  • GI: black, tarry stools
  • Liquid oral preparations may stain teeth
  • Injectable forms cause pain upon injection
19
Q

How to manage iron toxicity/overdose?

A

Antidote is deferoxamine

20
Q

Ferrous Sulfate drug profile?

A
  • Most frequently used oral iron
  • 300 mg BID or TID for adults
  • Each tablet contains 65 mg of elemental iron
21
Q

Ferrous Fumarate drug profile?

A
  • Contains largest amount of iron per gram of salt consumed
  • Ferrous salts are contraindicated in clients with liver disease and GI disorders
22
Q

Iron dextran drug profile?

A
  • May cause anaphylactic reactions, including major orthostatic hypotension
  • A test dose of 25 mg is administered before injecting full dose, then remainder is given after 1 hour
23
Q

Ferric gluconate drug profile?

A
  • Indicated for repletion of total body iron content in patients with iron-deficiency anemia who are undergoing hemodialysis
  • Risk of anaphylaxis is much less than with iron dextran, and a test dose is not required
  • Doses higher than 125 mg are associated with increased adverse events
24
Q

Iron Sucrose drug profile?

A
  • Adverse effects: hypotension (r/t infusion rates)
  • Infuse over 2.5 to 3.5 hours
25
Q

Folic acid drug profile?

A
  • Should not be used until actual cause of anemia is determined
  • Goal is to restore and maintain normal hematopoiesis
  • Antacids should be given 2 hours after folic acid
26
Q

Folic acid indication?

A
  • Prevention and treatment of megaloblastic anemia, and macrocytic anemias
  • Given during pregnancy to promote fetal development
27
Q

Folic acid contraindication?

A

Hypersensitivity and uncorrected anemias (neurological damage)

28
Q

Describe Cyanocobalamin (Vitamin B12).

A
  • Used to treat megaloblastic anemias
  • Administered orally or intranasally to treat vitamin B12 deficiency
  • Usually administered by deep intramuscular injection
29
Q

Folic acid drug interactions?

A
  • oral contraceptives
  • corticosteroids
  • sulfonamides
    can cause folic acid deficiency
30
Q

Folic acid PO pills nursing considerations and patient educations?

A
  • Administer oral folic acid with food
  • Keep away from children because oral forms may look like candy
31
Q

Iron PO Liquids nursing considerations?

A
  • Take through a straw to avoid staining tooth enamel
  • Give w/ ascorbic acid (OJ) to increase absorption
  • Remain upright for 15 to 30 minutes after oral iron doses
  • Eat foods high in iron and folic acid
32
Q

Iron Parenteral and IM nursing considerations?

A
  • For IM, administer deep into a large muscle mass using the Z-track method
    ~ Give in vastus lateralis

320 Pharmacology (36 decks)

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