Question 1

Colony Stimulating Factors ...

Accepted Answer

This is a type of Hematopoetic growth factor that stimulates production of particular blood cell types (stem cells to form colonies of mature cells). Also, it is a normal components of human breast milk. Infant harm has not been demonstrated. No special precautions are required during breast-feeding. (Burchum, p. 657)

Question 2

Erythropoietic Growth Factors (ESAs) ...

Accepted Answer

This type of Hematopoetic growth factor stimulate RBC production. Because they increase RBC production, this growth factor represent an alternative to infusions for patients with low RBC counts, including patients with Chronic Renal Failure and cancer patients undergoing myelosuppressive chemotherapy. Unfortunately, although these drugs can be beneficial, postmarketing surveillance has shown clear evidence of harm. In all patients, this growth factor may increase the risk of stroke, heart failure, blood clots, myocardial infarction (MI), and death. In patients with cancer, this growth factor may shorten time to tumor progression and reduce overall survival. E.g of this growth factor is called Erythropoeitin.

Question 3

Hematopoiesis

Accepted Answer

[BLANK] is the process by which our bodies make red blood cells, white blood cells, and platelets. The process is regulated in part by hematopoietic growth factors—naturally occurring hormones that stimulate the proliferation and differentiation of hematopoietic stem cells, and enhance function in the mature forms of those cells.

Question 4

Leukocytosis ...

Accepted Answer

When administered in doses greater than 5 mcg/kg/day, filgrastim has caused white blood cell counts to rise above 100,000/mm3 in 2% of patients. Although no adverse effects were associated with this degree of [BLANK], avoiding [BLANK] would nonetheless be prudent. Excessive white cell counts can be avoided by obtaining complete blood counts twice weekly during treatment and by reducing filgrastim dosage if [BLANK] develops.

Question 5

Leukopoietic Growth Factors ...

Accepted Answer

The [BLANK] growth factors stimulate production of leukocytes (white blood cells). Three preparations are available: filgrastim, pegfilgrastim, and sargramostim.

Question 6

Neutropenia ...

Accepted Answer

Filgrastim is given to elevate neutrophil counts, and thereby reduce the risk of infection. Specific indications are chronic severe [BLANK] and [BLANK] associated with cancer chemotherapy or BMT.

Question 7

Pure red-cell aplasia (PRCA)

Accepted Answer

Very, very rarely, treatment with epoetin leads to [BLANK], a condition characterized by severe anemia and a complete absence of erythrocyte precursor cells in bone marrow. The cause is production of neutralizing antibodies directed against epoetin itself as well as any native erythropoietin the body is still able to produce. In the absence of epoetin and erythropoietin, production of RBCs ceases. Because patients can no longer make erythrocytes, transfusions are required for survival. If evidence of [BLANK] develops, epoetin should be discontinued and blood should be assessed for neutralizing antibodies.

Question 8

Thrombocytopenia ...

Accepted Answer

Oprelvekin is administered to patients undergoing myelosuppressive chemotherapy to minimize [BLANK] (platelet deficiency) and to decrease the need for platelet transfusions. Because it stimulates the bone marrow, oprelvekin should not be given to patients with cancers of myeloid origin.

Question 9

Thrombopoietic Growth Factors ...

Accepted Answer

[BLANK] growth factors are endogenous compounds that stimulate production of platelets. At this time, oprelvekin is the only [BLANK] growth factor available. Two drugs with similar actions—romiplostim and eltrombopag

Question 10

Erythropoietin (Epoetin Alfa) What is it used for?

Accepted Answer

USES: - -Anemia associated with chronic renal failure - -Chemotherapy-induced anemia; - -For HIV-infected patients taking zidovudine - -Anemia in patients facing surgery

Question 11

Erythropoietin (Epoetin Alfa) What are the adverse effects?

Accepted Answer

ADVERSE EFFECTS: - -Hypertension - -Autoimmune pure red-cell aplasia (PRCA) which is very rare - -Cardiovascular events (Cardiac arrest, Hypertension, Heart failure, Thrombotic events (stroke and MI))

Question 12

Erythropoietin (Epoetin Alfa) What are some warnings to be aware of?

Accepted Answer

WARNINGS: - -Excessive dosage - -Cancer patients: ESAs can accelerate tumor progression and shorten life in certain cancer patients - -Renal failure patients: ESAs can increase the risk of serious cardiovascular events and death if hemoglobin levels are driven too high, - -Preoperative patients: Increased DVT risk. Premed with anticoagulants, - -Risk evaluation and mitigation strategy (Formal risk communication/informed consent)

Question 13

Erythropoietin (Epoetin Alfa) What are some safety alerts/warning for Dosage? Important to understand

Accepted Answer

DOSAGE: - -To minimize risks: Use minimum needed to gradually raise hemoglobin content to eliminate the need for RBC transfusions - -Monitor: Hemoglobin, Iron, CBC, Serum chemistry

Question 14

Filgrastim What is it?

Accepted Answer

Granulocyte colony-stimulating factor Leukopoietic growth factor Reduces the incidence of severe neutropenia Produces dose-dependent increase in circulating neutrophils Reduces the incidence of infection, need for hospitalization, and need for intravenous antibiotics

Question 15

Filgrastim What is it's therapeutic uses?

Accepted Answer

Patients Undergoing Myelosuppressive Chemotherapy. -Filgrastim is given to reduce the risk of infection in patients undergoing cancer chemotherapy. Many anticancer drugs act on the bone marrow to suppress production of neutrophils, greatly increasing the risk of infection. By stimulating neutrophil production, filgrastim can decrease infection risk. Patients Undergoing Bone Marrow Transplantation. -Filgrastim is given to shorten the duration of neutropenia in patients who have undergone high-dose chemotherapy followed by Bone Marrow Transplant. As noted, the drug is not used when the cancer is of myeloid origin. Severe Chronic Neutropenia. -Filgrastim provides effective treatment for congenital neutropenia (Kostmann's syndrome), a condition characterized by pronounced neutropenia and frequent, severe infections. Therapy helps resolve existing infections and decreases the incidence of subsequent infections. Because treatment is chronic, the cost is very high. In addition to congenital neutropenia, filgrastim is used in patients with idiopathic neutropenia and cyclic neutropenia.

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Week 7 - Chapter 56 - Hematopoietic Agents Flashcards

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