Hematopoietic Drugs Flashcards
Adverse effects of ferrous sulfate
- GI disturbances
- Iron toxicity: complex and involve GI symptoms. Hepatic failure and pulmonary edema- can be treated with deferoxamine
- Drug interactions: decreases absorption of tetracycline. Antacids reduce absorption.
What is used orally for iron deficiancy anemia or as prophylaxis during pregnancy?
Ferrous sulfate
A parenteral preparation of iron
Iron dextran- used only if oral is incapable or if oral is ineffective
Treatment of Vitamin B12 deficiency anemia and describe administration
Cyanocobalamin (purified crystalline vitamin B12)- given orally, parenterally or intranasally. Orally preferred but requires adequate secretion of intrinsic factor (pernicious anemia) from gastric parietal cells. Severe deficiency requires parenteral combo.
How would you treat megaloblastic anemia but without nervous system defects?
Folic acid. Vit. B12 deficiency has neurologic damage.
Erythropoietin
Epoetin alfa
A granulocyte colony-stimulating factor
Filgrastim
Thrombopoietic GF- Interleukin 11:
Oprelvekin
Adverse effects of iron dextran include…
-Severe (fatal) anaphylaxis from dextran.
MOA of folic acid. Administration? Indications?
Inactive form is converted to active form rapidly after administration; activation is vit B12-dependent under normal conditions.
- Usually given orally but can be injected.
- Indicated in megaloblastic anemia from folate deficiency, prophylaxis during pregnancy, initial treatment of B12 deficiency anemia.
When a patient has anemia of chronic renal failure, what should you give the patient?
Epoetin alfa.
-Also indicated in HIV patients taking AZT, chemo-induced anemia patients, and anemic patients scheduled for elective surgery.
What should you monitor and what are side effects with epoetin alfa?
- Monitor: Hb levels (target 10-12); CBC
- Adverse effects: HTN and CV events; directly related to rise in hematocrit.
What is secreted from a variety of cell types in response to inflammation and antigenic stimulation; act on myeloid precursors to stimulate production and activity of neutrophils, monocytes, macrophages and eosiniphils?
Myeloid growth factors: filgrastim
What is indicated to reduce risk of infection in patients with non-myeloid cancer undergoing myelosuppressive chemo and those undergoing BM transplant? Also for severe chronic neutropenia. Has an adverse effect of bone pain?
Filgrastim
What stimulates proliferation of megakaryocyte progenitor cells and maturation of megakaryocytes?
Thrombotic Growth factors: Oprelvekin
