Pharmacology of Neutropenia and Thrombocytopenia Flashcards
What are common things that cause Neutropenia?
Drug - ex. Chemo
Things that damage the bone marrow
Common symptoms of Neutropenia?
Recurrent sinusitis/otitis
Sore mouth
Low fever
Skin abscesses
What are 4 drugs that treat Neutropenia?
- Filgrastim
- Pegfilgrastim
- Sargramostim
- Pleroxifor
What are 4 drugs that treat Neutropenia?
- Filgrastim
- Pegfilgrastim
- Sargramostim
- Plerixafor
Between Filgrastim and Pegfilgrastim, which has fewer adverse effects and is the treatment of choice for Neutropenia?
Filgrastim
Pegfilgrastim has a _____ compared to Filgrastim
Longer half life
2 ways to administer Filgrastim (G-CSF)?
- 4 or 24 hour IV
- Continuous Subcutaneous infusion
How does Filgrastim (G-CSF) work?
Regulates production of neutrophils in bone marrow via progenitor proliferation and differentiation
Adverse effects of Filgrastim (C-CSF)?
Allergic reactions
Bone pain
Splenic rupture and Respiratory Distress Syndrome
Filgrastim must be administered ______ due to dividing cell vulnerability
24 hours after chemotherapy
How do you administer Sargramostim (GM-CSF)?
IV or Subcutaneous
How does Sargramostim (GM-CSF) work?
Increases production of neutrophils, eosinophils, monocytes/macrophages
Adverse effects of Sargramostim (GM-CSF)?
Edema
Shortness of breath
Worsened pre-existing renal/liver dysfunction
Gasping syndrome in premature infants
What in Sargramostim causes Grasping Syndrome in premature infants?
Benzyl Alcohol
How do you administer Plerixafor?
Subcutaneous injection
Plerixafor is a partial agonist for?
CXCR5 receptor
What does Plerixafor do?
Mobilizes hematopoietic stem cells to the plasma
Adverse effects of Plerixafor?
Hypersensitivity reactions
Which treatment for Neutropenia has little evidence of impact on clinical outcomes but does speed recovery from severe neutropenia?
Filgrastim
Which treatment for Neutropenia has a side effect of bone pain?
Filgrastim
Which treatment for Neutropenia has a side effect of edema?
Sargramostim
This drug metabolizes hematopoietic stem cells to the plasma
Plerixafor
- Treats Neutropenia
This drug increases production of neutrophils, eosinophils, monocytes/macrophages
Sargramostim
This drug regulates production of neutrophils in the bone marrow by proliferating and differentiating progenitor cells
Filgrastim
Why can’t you treat thrombocytopenia with Thrombopoietin?
Causes autoantibodies to be produced to platelets and leads to more severe thrombocytopenia
Why can’t you treat thrombocytopenia with Stem Cell Factor?
Has potent actions on progenitor cells and causes severe allergic reactions (found on mast cells)
What are 3 drugs to treat Thrombocytopenia?
- Oprelvekin
- Romiplostim
- Eltrombopag
What are 3 drugs to treat Thrombocytopenia?
- Oprelvekin
- Romiplostim
- Eltrombopag
How do you administer Oprelvekin (IL-11)?
Subcutaneous once a day
How does Oprelvekin (IL-11) work?
Increases Megakaryocytes via unknown mechanism
IL-3 and IL-6 cannot be used to treat Thrombocytopenia because?
Too toxic
Adverse effects of Oprelvekin?
Edema
Bloodshot eyes
Cardiac dysrhythmias
Allergic reactions
How do you administer Romiplostim?
Weekly subcutaneous injection
How does Romiplostim work?
Peptibody that binds to the TPO receptor
has no TPO similarity lol
Romiplostim increases?
Platelets
Adverse effects with Romiplostim?
Allergic reactions
How do you administor Eltrombopag?
Orally once a day
How does Eltrombopag work?
Non-peptide TPO receptor agonist
Adverse effects with Eltrombopag?
Hepatotoxicity
This drug may cause hepatotoxicity when treating Thrombocytopenia
Eltrombopag
This drug is well-tolerated and occasionally has allergic reactions when treating Thrombocytopenia
Romiplostim
This drug increases megakaryocytes when treating Thrombocytopenia
Oprelvekin
This drug can cause edema, blood shot eyes, and cardiac dysrythmias when treating Thrombocytopenia
Oprelvekin
