Phamacology 180: Hematologic System Drugs

• treats 2 types of anemia:
• 1. microcytic anemia -- iron deficient
• 2.megaloblastic (macrocytic) anemia
• --vitamin b-12 and folic acid defiency

• ferrous sulfate (Feosol)--oral form of iron
• iron dextrane (INFed)--IM or IV form of iron

vitamin b-12 supplements

folic acid supplements or vitamin b-12 of supplements+folic acid to hasten the reestablishment of hemopoisesis.

• 3 types:
• factor 8 concentrates
• factor 9 concentrates
• desmopressin (DDACP, or stimate)

Factor 8 concentrates

Factor 9 concentrates

• plasma derived (hemofil-M)
• --comes from the plasma human derived
• recombinant factor 8 (Advate)
• --comes from hamsters

• plasma derived (Alpha-nine SD)
• --comes from the plasma of human donors

• recombinant factor 9 (BeneFix)
• --comes from hamsters

the use of earlier generations for use to treat hemofilia

• two of several clotting factors in the clotting pathway
• co-factors for the clotting factor 10-A.

• allergic reactions:
• --may be mild and patients may only experience rash and itching.
• --may be severe and may experience anaphylaxis such as: difficulty breathing and airway swelling.

creutzfeld-jacob disease which has minimal risk with plasma derived products only

ok with recombinant factor derivatives

• monitor for mild allergic rxns (rash + itch)
• monitor for severe allergic rxns (airway swelling +anaphylactic shock)

epinephrine shot for anaphylaxis rxn

admin a diphenhydramine or benadryl for itching and rash

prions, the proteins that cause the disease resist inactivation.

• administer factors 8 or 9 IV slowly via bolus for 5-10 mins
• --reconstitute prior to adminstration
• --calculate the dose using the patients bodyweight and the percent of needed factor

to manage bleeding episodes or prophylactically to prevent bleeding.

admin dose on a regular dose schedule (1-3 dose per week)

assure patients that the risk for viral disease (hepatitis and HIV) is minimal

• recombinant 8 or 9 concentrates are safer than plasma derived concentrates
• --due to risk of prion transmitted infection (creutzfeld-jacob disease)

baseline of factor 8 or factor 9 level and monitor periodically to ensure the body maintains an adequate level.

• antidiuretic hormone (ADH)
• --effective short term on a patient with hemofilia A
• --are experiencing bleeding from a traumatic injury or preparing for surgery.

it stimulates the release of factor 8 and is used to treat a patient with hemofilia A.

it is only effective with patients whose body is able to produce some form of factor 8

• fluid retention + hyponatremia
• --result from stimulation of ADH

--hyponatremia develops with hypervolemia due to dilution of solutes in the blood.

• anticoagulants (aspirin)
• antiplatelets (heparin)
• thrombolytics (

• 1. interfere with conversion of factor 10 to thrombin
• 2. interfere with conversion of factor 10 to prothrombin
• 3. inhibits the action of vitamin K

used to prevent clots from forming and the extension of existing clots

cant dissolve already formed blood clots

thrombolytics

• factor Xa and thrombin inhibitors:
• -treat CVA that are evolving due to a thrombus in a cerebral vessel
• --prevent development of addL pulmonary emboli (DVT) when one or more already developed
• --prevent blood clot during open heart surgery, hemodialysis or blood transfusion