HEMATOLOGY - medications of hematopoietic agents (blood growth factors): anemia + leukopenia

Question 1

which drugs are erythropoietic growth factors? what do they treat?

Answer 1

EPOETIN ALFA (Erythropoietin) & DARBEPOETIN ALFA (Long acting Erythropoietin)
- stimulates RBC production

Question 2

what are the side effects of EPOETIN ALFA & DARBEPOETIN ALFA? how is the dose level? when can we see the initial effects?

Answer 2

initial effects within 1-2 weeks & reaches a max of 10-11 hgb lvl in 2-3 months –> reduce dose

side effects:
- increase risk of stroke, HF, MI, blood clots & death
- can increase tumor progression & reduce overall survival of cancer pts

we need to use to lowest dose possible to maintain a stable stable Hgb

Question 3

which drugs are leukopoietic growth factors? what do they do?

Answer 3

stimulates production of leukocytes
- FILGRASTIM (Neupogen): identical to human granulocyte colony stimulating factor (G-CSF)
- PEGFILGRASTIM (Neulasta, Onpro): long acting version of FILGRASTIM
- SARGRAMOSTIM (Leukine): identical to human granulocyte macrophage colony stimulating factor (GM-CSF)

Question 4

what is the exemplar drug for leukopoietic growth factors?

Answer 4

FILGRASTIM (identical to human G-CSF)

Question 5

what is FILGRASTIM’s MOA?

Answer 5

(just like human G-CSF)
- FILGRASTIM acts on cells in bone marrow –> increase production of neutrophils (under granulocytes) –> enhances phagocytic & cytotoxic actions of mature neutrophils

Question 6

what is FILGRASTIM’s therapeutic uses?

Answer 6

• pts undergoing myelosuppressive chemotherapy
• bone marrow transplantation
• harvesting of hematopoietic stem cells
• severe, chronic neutropenia

Question 7

what are the side effects of FILGRASTIM?

Answer 7

• bone pain: bc it stimulates bone marrow
• leukocytosis –> monitor WBC

Question 8

are there any drug interactions with FILGRASTIM?

Answer 8

nope

Question 9

what is the medication administration of FILGRASTIM?

Answer 9

IV or SQ

Question 10

how do we know if FILGRASTIM is effective?

Answer 10

monitor absolute neutrophil count to rise above 1000 + WBC

Question 11

what is absolute neutrophil count (ANC)?

Answer 11

allows us to know FILGRASTIM’s effectiveness
- has ANC of 2,500 - 6,000
- Neutropenia = ANC under 1,000
- risk of infection is high when ANC is below 500