Medications to treat Anemia

Question 1

Epoeitin Alfa

Erythropoietin

Answer 1

Stimulates bone marrow to create more red blood cells

Treats anemia associated with renal failure and AIDS, decreases the need for blood transfusions in patients undergoing surgery

Note the suffix of the trade name is “gen” this of this as gererating new RBC’s.

Also, typically abused by athletes, more RBC’s more O2 to the muscles - watch out for Polycythemia

Question 2

Assess for Epoeitin Alfa

Answer 2

Hx and physical exam and known allergies
Severe hypertension, pregnancy, anemia and abnormal renal function
Patients with cancer receiving the drugs to increase Hematocrit after antineoplastic chemotherapy.
Neurological and CV status, respirations
Appropriate lab values
Monitor for fluid volume and polycythemia

Question 3

Contraindications for Epoeitin Alfa

Answer 3

Allergy
Hemochromatosis
Hemolytic Anemia (or else they will have more iron in their bloodstream)
Normal Iron balance
Peptic ulcer, colitis, or regional enteritis

Question 4

Iron preparations Ferrous Sulfate (Feosol)

Adverse Effects

Answer 4

Oral - GI irratation and CNS toxicity
Parental iron is assoc. with severe anaphylactic reactions, local irritation, staining of the tissues, teeth, and phlebitis
Drink through a straw

Question 5

Drug to drug interactions Iron

Answer 5

Antacids
tetracycline
cimetidine
ciprofloxacin, norfloxacin, or ofloxacin
Chloramphenicol

Question 6

What nurses need to know about iron

Answer 6

Needs acidic environment to absorb
no antacids, give with OJ (need acidity), give on empty stomach for best absorption
Stools will be green/black, don’t be alarmed
Constipation - encourage fiber and fluids

Question 7

Antidote for iron overdose is

Answer 7

Deferoxamine Mesylate

Question 8

A 4 year old is brought to the E.D. The child is in shock. The mother states she found the child eating iron-fortified vitamin pills about 2 1/2 hours ago. The mother estimate the child ate close to 200 tablets. What medication would you expect the physician to order for the treatment iron toxicity?

Answer 8

Deferoxamine Mesylate (IV)

Question 9

Building blocks to RBC’s

Answer 9

Vitamin B12 (cyanocobalamin)
 injection given to pt. bc they lack intrinsic factor therefore cannot absorb PO, or give as nasal spray
Folic Acid (generic)

Question 10

Nursing considerations for Folic Acid
Derivatives and Vitamin B12
Assess:

Answer 10

Hx and physical exam and known allergy
pregnancy, lactation, and nasal erosion
affect, orientation, and reflexes, pulse, blood pressure, and perfusion, respirations and adventitious sounds, and CBC, hematocrit and iron levels.

Question 11

Prototype is Folic Acid and……

Answer 11

Vitamin B12