NEW 2022 EXAM UPDATE REVIEW FOR PHARM II (HEMATOLOGIC
DISORDERS)
What is a normal hgb range? - 12-18
What is a normal hct range? - 36-50%
What is a normal WBC range? - 4.5-11
What is a normal RBC range? - 4.2-6.2
What is a normal plt range? - 130,000-450,000
How are RBCs produced? - 1. erythropoietin growth factors: epoeitin alfa (PROCRIT)
-CAUSE RISE IN Hct (CONCENTRATION OF CIRCULATION RBC)
2. Use: chronic kidney disease, anemia, bone marrow suppression
3. 2x weekly Hct
4. SQ teaching
5. TAKES 2 WEEKS TO WORK-- transfusion PRBC
6. NEED Fe SUPPLEMENTATION AS WELL
What are the adverse effects of RBC therapy? - 1. HTN
2. cardiac events
3. DVT
What is WBC therapy? - 1. leukopoietic growth factor: FILGRASTIM
2. SQ
3. 4-6 days to work
,-cannot transfuse WBC--> "neutropenic precautions"
What are the adverse effects of WBC therapy? - 1. capillary leak syndrome
2. hypotension
3. cardiac issues
What is WBC suppression? - 1. Immune suppressants: CYCLOSPORINE
-For GVHD, solid organ transplant, autoimmune disorders
-PO: Q day
--NEED GOOD ADHERENCE
--life long therapy for organ transplant
What are the adverse effects of immune suppressants? - 1. gingival hyperplasia
2. neuropathy
3. nephrotoxicity
4. hyperkalemia
5. magnesium loss
6. RISK FOR SECONDARY CANCERS
7. RISK FOR INFECTIONS
What is anticoagulant therapy? - 1. prevent new clots
2. best for venous clots
3. HEPARIN, WARFARIN
--reversed w/ Vit K, Protamine Sulfate
What is antiplatelet therapy? - 1. lessens clotting pathway
2. Best for arterial clots
, 3. ASPIRIN
What is thrombolytic therapy? - 1. dissolve clots
2. ALTEPLASE
-most effective w/in 3 hrs of embolus formation
What are the adverse effects for any platelet therapy? - 1. minor bleeding or major bleeding
2. monitor PT/PTT, INR, Plts, BP, cog status
What is thrombopoietin receptor agonists therapy? - 1. RAMIPLOSTIM (NPLATE)
-increase plt production
-SQ, weekly
-Used for ITP
-NOT used for other platelet production disorders
-monitor plt level every 2 weeks
-$700/dose
-Adverse events: over production of abnormal blood cells or thrombosis
What is the antidote for Coumadin? - Vit K
What is the antidote for Heparin? - protamine sulfate
What is the antidote for tylenol? - Mucomyst
What is the antidote for anticoagulants? - Vit K, FFP
What is the antidote for Aspirin? - Sodium bicarbonate
DISORDERS)
What is a normal hgb range? - 12-18
What is a normal hct range? - 36-50%
What is a normal WBC range? - 4.5-11
What is a normal RBC range? - 4.2-6.2
What is a normal plt range? - 130,000-450,000
How are RBCs produced? - 1. erythropoietin growth factors: epoeitin alfa (PROCRIT)
-CAUSE RISE IN Hct (CONCENTRATION OF CIRCULATION RBC)
2. Use: chronic kidney disease, anemia, bone marrow suppression
3. 2x weekly Hct
4. SQ teaching
5. TAKES 2 WEEKS TO WORK-- transfusion PRBC
6. NEED Fe SUPPLEMENTATION AS WELL
What are the adverse effects of RBC therapy? - 1. HTN
2. cardiac events
3. DVT
What is WBC therapy? - 1. leukopoietic growth factor: FILGRASTIM
2. SQ
3. 4-6 days to work
,-cannot transfuse WBC--> "neutropenic precautions"
What are the adverse effects of WBC therapy? - 1. capillary leak syndrome
2. hypotension
3. cardiac issues
What is WBC suppression? - 1. Immune suppressants: CYCLOSPORINE
-For GVHD, solid organ transplant, autoimmune disorders
-PO: Q day
--NEED GOOD ADHERENCE
--life long therapy for organ transplant
What are the adverse effects of immune suppressants? - 1. gingival hyperplasia
2. neuropathy
3. nephrotoxicity
4. hyperkalemia
5. magnesium loss
6. RISK FOR SECONDARY CANCERS
7. RISK FOR INFECTIONS
What is anticoagulant therapy? - 1. prevent new clots
2. best for venous clots
3. HEPARIN, WARFARIN
--reversed w/ Vit K, Protamine Sulfate
What is antiplatelet therapy? - 1. lessens clotting pathway
2. Best for arterial clots
, 3. ASPIRIN
What is thrombolytic therapy? - 1. dissolve clots
2. ALTEPLASE
-most effective w/in 3 hrs of embolus formation
What are the adverse effects for any platelet therapy? - 1. minor bleeding or major bleeding
2. monitor PT/PTT, INR, Plts, BP, cog status
What is thrombopoietin receptor agonists therapy? - 1. RAMIPLOSTIM (NPLATE)
-increase plt production
-SQ, weekly
-Used for ITP
-NOT used for other platelet production disorders
-monitor plt level every 2 weeks
-$700/dose
-Adverse events: over production of abnormal blood cells or thrombosis
What is the antidote for Coumadin? - Vit K
What is the antidote for Heparin? - protamine sulfate
What is the antidote for tylenol? - Mucomyst
What is the antidote for anticoagulants? - Vit K, FFP
What is the antidote for Aspirin? - Sodium bicarbonate
