Platelet Disorder Pharmacology

  1. Patients with immune thrombocytopenia purpura (ITP), treat with _____
    IVIG (intravenous immune globulin)
  2. Patients with von Willebrand disease and hemophilia A, treat with ____
  3. When a rapid increase in platelet count is required in patients with ITP, what is the recommended treatment regimen?
    IVIG with corticosteroid use
  4. IVIG is purified Ig____ products manufactured from pooled ______ plasma.
    • IgG
    • Human
  5. Conditions for which IVIG has an established therapeutic role as immunomodulation therapy:
    • ITP
    • Guillain-Barre syndrome
    • Myasthenia gravis
  6. MOA of IVIG in ITP:
    Not fully understood, but appears to be due to competitive inhibition of Fc receptors on phagocytic cells, creating reticuloendothelial system blockade
  7. How is IVIG dosed?
    • Weight-based
    • Total dose can be split into doses given every day for 2-3 days
  8. ADR for IVIG:
    ADR can occur soon after infusion and can include HA, flushing, chills, myalgia, wheezing tachy cardia, lower back pain, nausea nausea and hypotension
  9. What can prevent IVIG infusion reaction?
    Premedicating patient with antihistamine or IV hydrocortisone
  10. T/F: IVIG is given by a short IV infusion over several hours. The adult fluid volume per dose is usually in the range of 750-1500 ml
  11. What is the black box warning for IVIG?
    • Renal failure likely due to high sucrose content
    • IgA deficient patient there could be anaphylaxis reactions
  12. IVIG can be used as replacement therapy in which condition?
    IgG deficiency and immunologic disease like myasthenia gravis
  13. T/F: Desmopressin is a synthetic arginine vasopressin (ADH) derivative used in hematology because it increase serum levels of von Willebrand factor and clotting factor VIII: aka ADH
  14. MOA of desmopressin?
    • V2 receptor Stimulator on endothelial cells  causes cell to release vWF
    • Increase water absorption
  15. Besides desmopressin, what are other treatment methods for vWD and hemophilia A?
    • vWF concentrates containing all vWF multimers
    • recombinant vWF
  16. Route of administration for desmopressin?
    • Nasally
    • IV
  17. Desmopressin ____ water absorption, and its affect on renal is_____
    • Increase
    • Hyponatremia, with CNS effects
  18. T/F: desmopressin can cause hyponatremia with CNS adverse reactions
    True; this drug has a high risk of decreasing serum osmolarity
  19. How to prevent desmopressin hyponatremia?
    fluid restriction. Fluid intake should be limited to a minimum from one hour before administration until at least 24 hours after administration
  20. T/F: Desmopressin nasal spray can treat hemophilia A and B but injection only treats hemophilia A
    • False; both only treat hemophilia A, no affect on hemophilia B no matter the route.
    • This is because desmopressin causes increased release of vWF which plays a role in stabilizing factor VIII not IX, which is seen in hemophilia B
  21. T/F: desmopressin will not increase the Factor VIII activity high enough to treat bleeding episodes seen in SEVERE hemophilia A
  22. High does desmopressin is used to treat _______, while lower dose of desmopressin is used for _____
    • High- hematological : vWD and hemophilia A
    • Lower dose – ADH replacement seen in diabetes insipidous
Card Set
Platelet Disorder Pharmacology
HemeOnc Final