Hematopoietic Growth Factors

Question 1

Epoetin Alfa

Answer 1

• IV & SubQ

MOA
- Erythropoietic growth factors => ↑ RBC production

Indication:

• Low RBC secondary to CKD
• Anemia after chemotherapy and HIV drug (zidovudine)
• Hasting of bone marrow function after a bone marrow transplant

Side effects:

• HTN (HA) –> monitor BP
• Increased H&H (monitor CBC & contact provider if Hgb is > 11 g/dL)
• Low iron and B12 & K (monitor and supplement as needed)

Adverse effects:
- Seizure, thromboembolic event (MI, CVA, DVT)

Contraindication:

• Pregnancy
• Uncontrolled HTN

Question 2

Filgrastim & Pegfilgrastim

Answer 2

• Filgrastim: IV & SubQ
• Pegfilgrastim: SubQ

MOA:
- Leukopoietic growth factors so increased neutrophil production

Indication:

• Neutropenia from anti-neoplastic drugs, HIV, neonatal neutropenia –> to prevent infection
• To increase WBC level prior to harvesting (autologous transplant)

Side Effects:

• Bone/joint/muscle pain –> managed with analgesics
• Leukocytosis absolute neutrophil >10,000 (monitor CBC)

Adverse Effects:

• Splenomegaly/rupture (with long-term use)
• Need to report any abd, back or shoulder pain

Contraindiation:
- Pregnancy

Fil –> White Name –> Cam ruptured spleen –> So has shoulder pain –> and muscle pain from soccer –> and he can’t get pregnant

Question 3

Oprelvekin

Answer 3

• SubQ

MOA:
- Thrombopoietic growth factor = increased platelet production

Indication:
- Chemotherapy-induced thrombocytopenia

Adverse Effects:

• Fluid retention & HF
• Tachydysrhythimia (A-fib/flutter)
• MI
• Conjunctival injection (red eye)
• Papilledema

Contraindication:
- Pregnancy

Ovechkin needs platelets because he gets beat up in hockey.
Oveckin Founded the Mafia. Caution Please!