Blood System Drugs

8/3/2019 Blood System Drugs

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Transport Nutrients to and from

tissue cells


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The arteries carry oxygenated blood (bloodthat has received oxygen from the lungs) fromthe heart to the rest of the body.

The blood then travels through the veins backto the heart and lungs, where it receives moreoxygen.


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Cell full of hemoglobin

Blood gets its bright red color whenhemoglobin picks up oxygen in thelungs.

As the blood travels through the body,the hemoglobin releases oxygen to thetissues.


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These are colorless cells and possess a nucleus.

They function in defending the body against

pathogens.

Lymphocytes agranulocytes - produceantibodies, the specific defence proteins.

Made in bone marrow and lymphatic tissue.


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Responsible for clotting of the blood

Responsible for repair of damaged tissue releasing the hormone platelet growthfactor.


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Iron deficiency anemia.

Anemia due to chronic disease. Anemia due to kidney disease.

Autoimmune hemolytic anemia.


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Neutropenia

Human immunodeficiencyvirus (HIV)

Leukemia


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Thrombocytopenia

Hemophilia


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Thrombosis is the formationof a clot.

A thrombus may form in any vessel,artery, or vein when blood flow isimpeded.


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Anticoagulants are used to prevent theformation and extension of a thrombus (bloodclot).


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GENERIC NAME TRADE NAME USES ADVERSEREACTIONS

Anisindioneah-nis-in-dye-on

Miradon Prophylaxis andtreatment of venous

thrombosis and its

extension; preventionand treatment ofatrial fibrillation with

embolization,prophylaxis andtreatment ofpulmonary embolism

Hemorrhage, nausea,

alopecia, dermatitis,

vomiting, anorexia,

abdominal cramping,

nausea,

Warfarin sodium Coumadin, generic Venous thrombosis,atrial fibrillation with

embolism, pulmonary

embolism (PE),prophylaxis ofsystemic embolismafter acute MI

Nausea, alopecia,

hemorrhage, urticaria,

dermatitis, vomiting,

anorexia, abdominalcramping, priapism


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GENERIC NAME

TRADE NAME

USES

ADVERSEREACTIONS

heparin Generic Thrombosis/embolism, diagnosis and

treatment of

disseminated

intravascular

coagulation (DIC),

prophylaxis of

deep vein

thrombosis (DVT),

clotting prevention

Hemorrhage,

chills, fever,

urticaria, local

irritation,

erythema, mild

pain, hematoma or

ulceration at the

injection site (IM or

SC), bruising

10,00020,000

units SC in divided

doses q812h;

500010,000 units

q46h intermittent

IV; 5000

40,000

units/d IV

infusion; 5000

unitsSC q2h before

surgery and 5000

units SC aftersurgery q812h

heparin sodium

lock flush solutionClearing

intermittent

infusion lines

(heparin lock) to

prevent clotformation at site

None significant 10100 units/mLheparin solution


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dalteparin sodium Fragmin Unstableangina/non Q-

wave MI, DVT

prophylaxis

Hemorrhage,

bruising,

thrombocy-

topenia, chills,

fever, pain,erythema and

irritation at site of

injection

Angina/MI: 120

IU/kg, SC q12h

with concurrent

oral aspirin; DVT:

2500 IU SC daily

Danaparoid

sodiumOrgaran Prophylaxis of

DVT, after hip

replacement

surgery

Hemorrhage,

bruising, thrombo-

cytopenia,

hyperkalemia,

hypersensitivity,

fever, pain anderythema at

injection site

750 anti-Xa units

BID SC


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Enoxaparin sodiumLovenox DVT and prophylaxis,

DVT and pulmonary

embolism (PE)

treatment, unstable

angina/nonQ-wave

MI

Hemorrhage, bruising,

thrombo-cytopenia,

hyperkalemia,

hypersensitivity, fever,

pain and erythema at

injection site

DVT prophylaxis: 30

mg q12h SC or 40 mg

once daily SC; in

abdominal surgery for

patients at risk for

thromboembolic

complications: 40

mg/d SC;DVT/PE treatment:1 mg/kg SC q12h;unstableangina, nonQ-wave

MI:1 mg/kg SC

q12hANTICOAGULA

NTSTinzaparin sodium Innohep Treatment of acute,

symptomatic DVTwith

or without pulmonary

emboli when given

with warfarin sodium

Hemorrhage, bruising,thrombo-cytopenia,

hyperkalemia,

hypersensitivity, fever,

pain and erythema at

injection site

175 anti-Xa IU/kg/dSC once daily; 175

IU/kg/d SC once daily

until the patient has

been successfully

anticoagulated with

warfarin


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Phytonadione

(vitamin K)Aqua-mephyton,

Mephyton, genericPrevention and

treatment of hypopro-

thrombinemia

associated with

excessivedoses of oralanticoagulants

Gastric upset,

unusual taste,

flushing, rash,

urticaria, erythema,

pain and/or swelling

at injection site

may repeat PO in

1248 h PO, IM,

2.5

10 mg, or in 6

8

h after parenteral

dose

Protamine sulfateAcute management of

heparin overdosage

(neutralizes heparin)

Dyspnea,

bradycardia,

hypotension,hypertension,

bleeding,

hypersensitivity

reactions

Dose is determined

by amount of heparin

in body and the timethat has elapsed

since the heparin was

given; the longerthe interval, the

smaller thedose required.Adult and pediatric:

1mg IVneutralizes 90 USP

units ofheparin derived from

lungtissue or 115 USP

units ofheparin derived fromintestinal mucosa


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Thrombolytics are a group of drugsused to dissolve certain types of

blood clots and reopen blood vesselsafter they have been occluded.


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GENERIC NAME TRADE NAME* USES ADVERSE REACTIONS DOSAGE RANGES

alteplase, Activase Acute myocardial Bleeding (GU, gingival, AMI: total dose of 100 mg

recombinant infarction (AMI), retroperitoneal), and IV given as 60 mg

acute ischemic epistaxis, ecchymosis 1st h, 20 mg 2nd h

stroke, pulmonary and 20 mg over 3rd h

embolism (PE) for patients < 65 kg,

decrease dose to

1.25 mg/kg

reteplase, Retavase AMI Bleeding (GI, GU, or at injection 10 plus 10 U double bolus

recombinant site), intracranial hemorrhage, IV over 2 min each with the

anemia 2nd bolus given 30 min

after the 1st

streptokinase Streptase AMI, DVT, PE, Minor bleeding (superficial and Lysis of coronary arteryembolism surface) and major bleeding thrombosis, 20,000

(internal and severe) IU directly into vein;

PE, DVT, embolism:

250,000 IU IV

over 30 min followed by

100,000 IU for 2472 h


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tenecteplase TNKase AMI Bleeding (GI, GU, or at injection Dosage based on weight,site), intracranial hemorrhage, not to exceed 50 mg IV

anemia

urokinase Abbokinase PE, lysis of coronary Minor bleeding (superficial and PE: 4400 IU/kg IV

artery thrombi, IV surface) and major bleeding over 10 min, followed by

catheter clearance (internal and severe) 4400 IU/kg/hr for 12 h;

lysis of thrombi: 6000IU/min IV for 2 h; IV

catheter clearance: see

packaged instructions


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darbepoetin alfa Aranesp Anemia associated Hypertension, hypotension, 0.45 mcg/kgwith chronic headache, diarrhea, vomiting, IV, SC weeklyrenal failure nausea, myalgia, infection,

cardiac arrhythmias, cardiacarrest

epoetin alfa Epogen, Anemia associated Hypertension, headache, Individualized dosage CRF

(Erythropoietin; procrit with chronic renal tachycardia, nausea, vomiting, 50100 U/kg (3 times(EPO) failure, anemia related skin rashes, fever, skin reaction weekly IV or SC),

to zidovudine therapy at injection site maintenance based onin HIV-infected patients, HCT, generally 25 U/kg

anemia in cancer 3 times weekly;patients receiving zidovudine-treated HIV

chemotherapy, infected patients: 100anemia in patients who U/kg 3 times weekly;

undergo elective cancer: 150 U/kg 3nonvascular surgery times weekly;surgery: 300 U/kg/d

SC x 10 d beforesurgery, on day ofsurgery and 4 days

after surgery


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ferrous fumarate Feostat, Prevention and GI irritation, nausea, vomiting, Daily requirements:

(33% elemental generic treatment of iron constipation, diarrhea, males, 10 mg/d PO;iron) deficiency anemia allergic reactions females, 18 mg/d PO;

during pregnancy andlactation, 3060 mg/dPO; replacement indeficiency states,90300 mg/d(6 mg/kg/d) POfor 610 months

ferrous gluconate Fergon, Prevention and GI irritation, nausea, vomiting, Daily requirements:(11.6% elemental generic treatment of iron constipation, diarrhea, males, 10 mg/d PO;iron) deficiency anemia allergic reactions females, 18 mg/d PO;

during pregnancy andlactation, 3060 mg/dPO; replacement indeficiency states,

90300 mg/d(6 mg/kg/d) POfor 610 months


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ferrous sulfate Feosol, Prevention and GI irritation, nausea, vomiting, Daily requirements:(20% elemental Fer-In-Sol, treatment of iron onstipation, diarrhea, males, 10 mg/d PO;iron) generic eficiency anemia allergic reactions females, 18 mg/d PO;

during pregnancy andlactation, 3060 mg/dPO; replacement indeficiency states,90300 mg/d(6 mg/kg/d) POfor 610 months

folic acid Folvite, Megaloblastic anemia Allergic sensitization Up to 1 mg/dgeneric due to deficiency of PO, IM, IV, SCfolic acid

iron dextran DexFerrum, Iron deficiency Anaphylactoid reactions, Dosage based on bodyInFeD, anemia soreness and inflammation weight and gramsGeneric at injection site, chest pain, percent (g/dL) of

arthralgia, backache, hemoglobin IV, IMconvulsions, pruritus,

abdominal pain, nausea,vomiting, dyspnea

iron sucrose Venofer Iron deficiency Hypotension, cramps, leg 100 mg elemental ironanemia cramps, nausea, headache, slow IV or during

vomiting, diarrhea, dizziness dialysis session


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Ieucovorin Wellcovorin, Treatment of Allergic sensitization, Megaloblastic anemia:

Calcium generic megaloblastic urticaria, anaphylaxis 1 mg/d IM rescue after

anemia leucovorin methotrexate therapy:

rescue after high-dose 1215 g/m2 PO

methotrexate therapy or parentearally then

in osteosarcoma 10 mg/m2 q6h for 72 h;

check serum creatinine

after 24 h; if 50% greater

than the pretreatment

level, increase Ieucovorin

dose to 100 mg/m2 until

serum methotrexate level

is 15 _ 10-8 M

sodium ferric Ferrlecit Iron deficiency Flushing, hypotension, 125 mg of elemental iron

gluconate syncope, tachycardia, IV over at least

complex dizziness, pruritus, dyspnea, 10 min

conjunctivitis, hyperkalemia

vitamin B12 generic B12 deficiencies as seen Mild diarrhea, itching, Schillings test:

(cyanocobalamin) in pernicious anemia, edema, anaphylaxis 1001000 mcg/d x

GI pathology; also 2 wk, then 100-1000

used when mcg IM q mo

requirements for the

vitamin are increased;

Schillings test

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