Take Your Breaks
Name the growth factor & one drug example: I stimulate red blood cell production
Erythropoiesis- stimulating factors, Epoetin alfa (Epogen)
___, a term used to describe platelet deficiency, can result from autoimmune dysfunction or medication administration (e.g., antineoplastic therapy)
Thrombocytopenia
Name the growth factor & one drug example: I stimulate the production of leukocytes
Colony- stimulating factors, Filgrastim (Neupogen)
The three general goals of chemotherapy (antineoplastic drugs) depend on many factors specific to the patient & illness & include ___, ___, or ___.
Cure, control, palliation
Name the growth factor & one drug example: I stimulate platelet production
Platelet enhancers, Avatrombopag (Doptelet)
The most common form of anemia worldwide, more than 50% of pts diagnosed w/ the disorder have active GI bleeding, but in the US, it most commonly affects women of child- bearing age.
Iron deficiency anemia
Name the drug & class: this medication is the leading cause of fatal poisoning in children, can be administered IV/IM/PO (but if taken PO should be given 1hr before or 2hrs after a meal/meds & w/ vitamin C) and if too much is taken, its antidote is Deferoxamine (Desferal)
Ferrous Sulfate (Feosol)
Name the drug class: medications within this class can either enhance or suppress immune response, produce effects directly or indirectly, & may cause infusion reactions (some require continuous monitoring during infusion)
Biologic Response Modifiers (e.g., cytokines, monoclonal antibodies, small molecule therapies)
____, the second line treatment of thrombocytopenia when first line treatments have failed
Thrombopoiesis stimulating agents, Romiplostim (Nplate)
___ a black box warning for many anti-neoplastic drugs, requires regular CBC monitoring before, during, and after treatment, to see signs of.
severe myelosuppression
___ the ratio of the # of replicating cells to resting cells; solid tumors have a low ___ making them less sensitive to antineoplastic drugs whereas certain leukemias have a high ___, making them more sensitive to antineoplastic drugs
growth fraction
Name the drug & class: Especially useful in pts w/ CKD, this drug is typically administered SubQ (don't shake the vial), can cause HTN &/or seizures (requiring close monitoring the first two weeks of initiation) & may lead to polycythemia in the event of an overdose.
Epoetin Alfa (Epogen), Erythropoiesis- stimulating drug
Name three: Fist line treatments of thrombocytopenia
Corticosteroids (e.g., Dex or Pred), IVIG (e.g., Gammagard), IVRhlg (e.g., RhoGam)
Colony stimulating factor, Filgrastim (Neupogen)
Typically ordered in adult pts when their Hgb is < 7g/dL; requires VS monitoring before, 15min post initiation, & post completion of the infusion. It must be started w/in 30 minutes of retrieval and must be run w/in 4 hours
RBC infusion
Name the drug & class: this medication, often required for life, is initiated IM or SubQ but can be offered via intranasal nasal spray once a therapeutic response has been met. This medication can reverse symptoms in days to weeks, but is contraindicated in the treatment of folic acid deficiency anemia
Vitamin B12 supplement, Cyanocobalamin (Nascobal)
Name the drug & class: this antineoplastic can lead to severe myelosuppression & cardiotoxicity, requiring an echocardiogram & EKG before initiation. St. John's Wort can decrease its effectiveness & if it infiltrates during infusion ice should be applied immediately
Doxorubicin, Antitumor antibiotic
Name the drug & class: this medication is a synthetic form of a natural vitamin needed for DNA synthesis. Indicated for use in pregnant women & those w/ alcohol use disorder, it will reverse deficiency symptoms in 5- 7 days.
Folic Acid (Focalin)
If the absolute neutrophil count (ANC) is less than ___, pts are HIGHLY susceptible to infection.
1500 cells/mL
Name the drug & class: A folic acid analog, this medication is indicated for use in various cancers as well as certain autoimmune disorders (i.e., RA, UC, Psoriasis), can cause pulmonary & hepatic toxicity, and should not be used w/ NSAIDs or ASA.
Antimetabolite, Methotrexate
Name the anemia classification: the RBCs in this type of anemia are abnormally large but have a normal hemoglobin concentration
Macrocytic- Normochromic anemia (e.g., Pernicious anemia, Folic acid deficiency anemia)
The lowest point to which the erythrocyte, neutrophil, or platelet count is depressed by the drug
Nadir
Name the drug & class: this medication is indicated for use in the treatment of breast cancer. It should be taken with food, can cause an idiosyncratic increase in tumor size, & is contraindicated in pts w/ a hx of thrombolytic disease
Tamoxifen, Selective estrogen receptor modifier (SERM)
Name the drug & class: this antineoplastic can cause severe myelosuppression, nervous system toxicity, & paralytic ileus (esp in children). Extravasation can cause intense pain & tissue necrosis & if a cold compress is applied, it will worsen the drugs toxicity
Vinca alkaloid, Vincristine
Name the anemia classification: this type of anemia is defined as the destruction or depletion of normal erythroblasts or mature erythrocytes
Normocytic- normochromic, ex) Sickle Cell Anemia, Aplastic anemia