HEMATOPOIETIC

Question 1

process in which the body uses to make red blood cells; occurs in bone marrow ( pelvis, sternum, rib, vertebra)

Answer 1

hemotopoiesis

Question 2

what is used to correct more chronic causes of decreased RBC counts?

what are some of the chronic causes?

Answer 2

epoetin alfa (epogen, procrit)

causes can be: chronic renal failure, anemia, chemotherapy, for pts o zidovudine therapy for HIV.

Question 3

the goal of treatment for epoetin alfa is?

Answer 3

hemoglobin 10-12

not normal but the goal.

Question 4

is epoetin alfa an emergency drug?

Answer 4

NO

Question 5

with epoetin alfa, the hemocrit increases about
__ per week during the initial weeks of treatment. some patients may need __ of treatment to change the hemocrit signficantly.

Answer 5

2%

2-6 weeks

Question 6

most significant adverse effect for epoetin alfa is?

Answer 6

HTN! (give anytihypertensive meds)

also, MI, stroke, heart failure, cardiac arrest, & MALIGNANCY PROGRESSION!

Question 7

dont give epoetin alfa to patients with cancer who are NOT _____: monitor tumor progression; only give to cancer patients whose hemogloin level is___.

Answer 7

undergoing chemo

less than 10

Question 8

what should you instruct your patient to do while taking epoetin alfa?

Answer 8

• frequent BP checks
• report HA
• report suddent chest pain, weakness, numbness, paralysis, vision changes, n/v or seizures.
• report worsening symptoms of malignancy

Question 9

used to increase neutrophil production in bone marrow

Answer 9

filgastim

Question 10

sometimes filgastim is used for patients who are being prepared for donation of WBC which is called ___.

Answer 10

leukapheresis

Question 11

filgastim should be STOPPED when___.

Answer 11

the absolute neutrophil count reaches 10,000 or greater

Question 12

what is the formulation that is sometimes put into filgastim?
what does it do?

Answer 12

polyethylene glycol.

increases half life longer so doesnt have to be dosed as frequently.

Question 13

what drug do you give first? chemo or stimulator drug?

Answer 13

chemo drug 1st, then stimulator drug

we wait 24 hrs after chemo drug!!
filgastim

Question 14

do not administer filgastim within 24 hrs of ___.

Answer 14

cytotoxic chemotherapy!

Question 15

biggest AE of filgastim is ___.

Answer 15

BONE PAIN!, fever

others are:
leukocytosis (can make too many leukocytes), spenomegaly

Question 16

with filgastim you monitor what?

Answer 16

• CBC twice a week during treatment
• give lower dose or stop treatment for WBC above 10,000
• monitor degree of bone pain
• monitor temp
• give tylenol or opioid (if bone pain is severe)
• monitor for spleen enlargement

Question 17

given to patients that are undergoing myelosuppressive chemothereapy for nonmyeloid cancers.

Answer 17

oprelvekin

Question 18

giving oprelvekin can decrease the chance of the patient needed a ___.

Answer 18

platelet infusion

Question 19

goal of treatment for oprelvekin ?

Answer 19

to get the platelet count to about 50,000. (normal platelet count is 150-450)

Question 20

dosing for oprelvekin should be initiated ____ after the completion of chemotherapy.

Answer 20

6-24 hours

Question 21

dosing beyond ___ per treatment course is NOT recommended for oprelvekin.

Answer 21

21 days

Question 22

major AE for oprelvekin is?

Answer 22

1. fluid retention
2. cardiac dysrhythmias
3. allergic reactions

Question 23

when would you STOP oprelvekin?

Answer 23

dysrhythmias
for significant symptoms of fluid overload
for indicatons of an allergic reaction
for pulmonary edema (listen to crackles in chest)

Question 24

patient getting an IV of oprelvekin…. is this is an question on test, what will NOT be an answer ?

Answer 24

the eye!!

Question 25

what are the things that stimulate erythropoietin

Answer 25

•Hemorrhage
COPD
•Anemia
•High Altitudes