1 / 20

Drugs for Hemopoietic Disorders

makelina
Download Presentation

Drugs for Hemopoietic Disorders

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. Drugs for Hemopoietic Disorders

    2. Hematopoiesis

    3. Control of Hematopoiesis What influences hematopoietic control? With what does the process begin? How is the process regulated?

    4. Hematopoietic Growth Factor Natural hormone Promotes some aspect of blood formation Table 28.1, p. 395 What are the goals of pharmacologic use of hematopoietic growth factors?

    5. Erythropoiesis What organ secretes erythropoietin? What is the implication of failure of this organ? Create a flow chart diagram that illustrates erythropoiesis. Describe a functional erythrocyte.

    6. Erythropoietin Pharmacology Prototype: epoetin alfa (Epogen) p. 396 3 X /week dosing Do not shake New generation: darbepoetin alfa (Aranesp) Same action, efficacy and safety profile as Epogen 1 X /week dosing What is a key indication for erythropoietin therapy?

    7. Leukopoiesis Why is control of leukopoiesis more complicated than that of erythropoiesis? Identify the two basic categories of WBC growth factors.

    8. Colony Stimulating Factors Natural substances Stimulate white blood cell production Activates existing WBCs? enhanced function: Increased migration of leukocytes to antigens Increased antibody toxicity Increased phagocytosis Active at very low concentrations Name indicates type of blood cell stimulated

    9. Colony Stimulating Factors Describe the overall goal of treatment. Identify indications for use. Prototype: filgrastim (Neupogen) p. 399 Similar to endogenous G-CSF Indications: primary neutropenia; neutropenia secondary to cancer chemotherapy Compare and contrast filgrastim and pegfilgrastim.

    10. Colony Stimulating Factors sangramostin (Leukine) Similar to endogenous GM-CSF Indications Neutropenia r/t acute myelogenous leukemia Autologous bone marrow transplantation Nursing Considerations/Teaching Pp. 398 - 399

    11. Thrombocytopoiesis Begins with megakaryocytes Controlled by thrombopoietin Oprelvekin (Neumega) Stimulates production of megakaryocytes and thrombopoietin Functionally equivalent to endogenous interleukin-2 Indicated for thrombocytopenia secondary to cancer chemotherapy

    12. Anemia Discuss the statement: “anemia is not a condition but a sign of underlying pathology.” Describe the overarching affect of anemia, regardless of the type or underlying process. Identify the categories of anemia. What erythrocyte characteristics are used to classify anemia?

    13. Case Study Mrs. Bowman is a 37-year-old female who normally walks 2 miles a day. During the past two weeks she can only walk one mile with rest periods. When she stops to rest she notices she is breathing hard and her heart feels like it is pounding. What may Mrs. Bowman be experiencing? What is causing the tachycardia and tachypnea?

    14. The Case Unfolds Two weeks later Mrs. Bowman is not able to walk any distance without experiencing shortness of breath and tachycardia. She rests all the time but can’t get over feeling tired. She has no energy. She has almost fainted when getting out of bed the last two mornings. Her co-workers have commented on how pale she is and she can’t stay focused on her work.

    15. Case Questions What do you expect Mrs. Bowman is experiencing at this point? Why are these symptoms occurring? What could be the cause of the symptoms? As a nurse, what would you suggest to Mrs. Bowman? What therapy would you expect for Mrs. Bowman?

    16. B12 Deficiency Aka: pernicious (megaloblastic) anemia Affects hematologic and nervous system Macrocytic RBCs Symptoms Evolve Often nonspecific Pharmacotherapeutics Cyancobalamin (Crystamine) p. 403

    17. Folic Acid Linked to vitamin B12 metabolism Does not require intrinsic factor Describe the primary cause of folic acid deficiency. Compare and contrast the symptoms of folic acid deficiency anemia and vitamin B12 deficiency anemia.

    18. Iron Essential to homeostasis Free iron is toxic Binds to protein complexes Iron deficiency most common cause of nutritional anemia Balance maintained through increased absorption from proximal small intestine Deficiency contributes to ? erythropoiesis

    19. Iron Pharmacotherapy Common iron supplements Ferrous sulfate Ferrous gluconate Ferrous fumarate Slow release product Carbonyl iron (Feosol-caps) Parenteral IM or IV

    20. Iron Pharmacotherapy Questions Discuss the benefits and barriers to use of slow-release iron preparations. Identify the indication for parenteral iron therapy. Identify a key concern of parenteral iron therapy. How can oral iron absorption be enhanced? What may inhibit oral iron absorption? What will dictate the duration of iron therapy?

    21. Iron Pharmacotherapy What are anticipated reactions to oral iron? How would you minimize these reactions? What could be affected when the anticipated reactions are minimized? Nursing Considerations/Teaching: pp. 404, 406

More Related