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Flashcards in Anemia Drugs Deck (13):
0

Epoetin Alfa (Epogen)
(Functional Classification)

Antianemic, biologic modifier, hormone

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Epoetin Alfa (Epogen)
(Chemical Classification)

Amino Acid Polypeptide

2

Epoetin Alfa (Epogen)
(Mechanism of Action)

Erythropoietin is 1 factor controlling the rate of red cell production; product is developed by recombinant DNA technology

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Epoetin Alfa (Epogen)
(Uses)

Anemia caused by reduced endogenous erythropoietin production, primarily end-stage renal disease; to correct hemostatic defect in uremia; anemia due to AZT treatment in patients with HIV or those receiving chemotherapy; reduction of allogenic blood transfusion in surgery patients

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Epoetin Alfa (Epogen)
(Contraindications)

Hypersensitivity to mammalian-cell-derived products, human albumin; uncontrolled hypertension

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Epoetin Alfa (Epogen)
(Side Effect)

CNS: SEIZURES, coldness, sweating, headache
CV: Hypertension, HYPERTENSIVE ENCEPHALOPATHY, CHF, edema, DVT
INTEG: pruritus, rash, inj site reaction
MISC: iron deficiency
MS: bone pain
RESP: cough

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Epoetin Alfa (Epogen)
(Nursing Considerations)

ASSESS:
-Renal studies: urinalysis, protein, blood, BUN, creatininel I&O, report drop in output /=20%, ferritin >/=100ng/ml; Hct 2x/wk until stabilized in target range (30%-36%) then at regular intervals; those with endogenous erythropoietin levels of 12g/dl
-BP, check for rising BP as Hct rises, antihypertensives may be needed; hypertension may occur rapidly, leading to hypertensive encephalopathy
-CNS symptoms: coldness, sweating, pain in long bones; for seizures if Hct is increased within 2wk by 4pts
-Hypersensitivity reactions: skin rashes, urticaria (rare), antibody development does not occur
-PURE CELL APLASIA (PRCA) in absence of other causes; evaluate by testing sera for recombinant erythropoetin antibodies; any loss of response to epoetin should be evaluated
-Dialysis patients: thrill, bruit of shunts; monitor for circulation impairment
-SEIZURES: place patient on seizure precautions if increase of >/= 4 points HCT in 2wk, increased BP; more common in chronic renal failure during the first 90 days of treatment

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Folic Acid
(Functional Classification)

Vitamin B complex group, water-soluble vitamin

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Folic Acid
(Mechanism of Action)

Needed for erythropoiesis; increases RBC, WBC, platelet formation with megaloblastic anemias

9

Folic Acid
(Uses)

Megaloblastic or macrocytic anemia caused by folic acid deficiency; hepatic disease, alcoholism, hemolysis, intestinal obstruction, pregnancy to reduce risk for neural tube defects

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Folic Acid
(Contraindications)

Hypersensitivity

11

Folic Acid
(Side Effects)

CNS: confusion, depression, excitability, irritability
GI: anorexia, nausea
INTEG: pruritus, rash, erythema
RESP: BRONCHOSPASM
SYST: ANAPHYLAXIS (RARE)

12

Folic Acid
(Nursing Considerations)

ASSESS:
-Megaloblastic anemia: fatigue, dyspnea, weakness
-Hgb, Hct, reticulocyte count
-Nutritional status: bran, yeast, dried beans, nuts, fruits, fresh vegetables, asparagus
-Products currently taken: estrogen carBAMazepine, glucocorticoids, hydantoins; these products may cause increased folic acid use by body and contribute to deficiency if taking other neurotoxic products