Hematologic System Pharmacology Flashcards

Classification: Iron Preparation
Use: Anemia
Adverse Reactions:
- Toxicity (nausea, vomiting, diarrhea, acidosis, shock)
- Constipation
Nursing Considerations/Patient Instructions:
- Use a straw to prevent teeth staining.
- Administer Desferal for toxicity.
- Take on an empty stomach.
- Spread doses throughout the day.
- Increase fluid and fiber intake.

Classification: Iron Preparation
Use: Anemia
Adverse Reactions:
- GI upset, toxicity more likely with parenteral form
- Hypersensitivity
Nursing Considerations:
- Administer a test dose.
- Give IM with Z-track technique.
- Monitor BP.
- Have epinephrine ready.

Classification: Vitamin, Antianemic
Use: Megaloblastic anemia
Adverse Reactions:
- Warmth/flushing with IV infusion
Nursing Considerations:
- Monitor reticulocyte count, CBC, RBC, HCT, HGB.
- Avoid alcohol.

Classification: Antihemophilic agent
Use: Hemophilia B
Adverse Reactions:
- Anaphylaxis
Notes: Safer than Factor IX and prevents the risk of transmitting Creutzfeldt-Jacob disease.

Classification: Anticoagulant, Vitamin K inhibitor
Use: Prevent thrombi
Adverse Reactions:
- Bleeding
- Toxicity
Nursing Considerations:
- Monitor PT/INR (keep INR 2-3).
- Keep Vitamin K on hand for antidote.
- Use NSAIDs with caution.
- Limit Vitamin K-rich foods.
- Interacts with many drugs.
- Longer duration of action, give orally QD.

Classification: Thrombin inhibitor
Use: Prevent thrombi (DVT prophylaxis)
Adverse Reactions:
- Bleeding
Nursing Considerations:
- Monitor for bleeding
- Give deep Subcut. At least 2 inches from umbilicus.

Classification: Antiplatelet
Use: Prevent thrombi
Adverse Reactions:
- Bleeding
Nursing Considerations:
- Monitor for bleeding
- Usual antiplatelet dose
- Caution in liver/kidney disease
- Risk of Reye’s syndrome

Classification: Antiplatelet
Use: Prevent thrombi
Adverse Reactions:
- Gastric bleeding
- Thrombocytopenic purpura
Nursing Considerations:
- Caution with peptic ulcer disease
- Monitor for bleeding gums, petechiae, bruising
- Monitor platelet count
- Avoid contact sports

Classification: Thrombolytic (“Clot Buster”)
Use: Breakdown existing clots, pulmonary emboli
Adverse Reactions:
- Intracranial bleeding
Nursing Considerations:
- Monitor for headache, LOC, one-sided weakness
- Use Amicar if patient bleeds too much
- Use within 4-6 hours of clot formation (within 3 hours for ischemic stroke)

Classification: Erythropoietic growth factor
Use: Hematopoiesis, increase production of RBCs
Adverse Reactions:
- Hypertension
Nursing Considerations:
- Give subcutaneously
- Insert needle into vial ONCE
- Discard if colored or cloudy
- Monitor BP

Classification: Leukopoietic growth factor
Use: Hematopoiesis, increase production of neutrophils (patients on chemotherapy or bone marrow transplant)
Adverse Reactions:
- Enlarged spleen
- Leukocytosis
Nursing Considerations:
- Don’t give to patients with E. coli sensitivity or acute respiratory syndrome
- Report abdominal pain
- Notify provider if WBC count over 10,000

Classification: Thrombopoietic growth factor
Use: Thrombocytopenia, increases platelet production
Adverse Reactions:
- Conjunctivitis
- Blurred vision
- Fluid retention
- Palpitations
- Cardiac dysrhythmias
- Dizziness
Nursing Considerations:
- Monitor vision
- Check for edema
- Monitor pulse

Classification: Anticoagulant (short duration of action)
Use: Thromboembolic disorders, prevents existing clots from getting larger, prevents new clots from forming
Adverse Reactions:
- Bleeding
Nursing Considerations:
- Avoid NSAIDs
- Monitor aPTT (60-80 sec) before each dose
- Antidote: protamine sulfate
Client Teaching Points:
* Know how to administer subcutaneously (at least 2 inches from umbilicus)
* Contraindicated in severe thrombocytopenia