DRUG STUDY DRUG GENERIC NAME: Erythropoietin BRAND NAME: Eposino DOSE: 4000 IU ROUTE: S.

Q FREQUENCY: TID X 6 doses MUSCKULOSKELETAL: arthralgia RESPIRATORY: cough, shortness of breath. SKIN: infection site reactions, rash, urticaria. INDICATION Anemia caused by Chronic renal failure ACTION Mimics effects of erythropoietin. Functions as a growth factor and as a differentiating factor, enhancing RBC production. ADVERSE REACTION CNS: asthenia, dizziness, fatigue, headache, paresthesia, seizures. CV: edema, hypertension, increased clotting of arteriovenous grafts. GI: abdominal pain and constipation (in children) diarrhea, nausea, vomiting. CONTRAINDICATIONS Contraindicated in patient hypersensitivity to products derived from mammal cells or albumin (human) and in those with uncontrolled hypertension. NURSING CONSIDERATIONS Before starting therapy, evaluate patients iron status. Patient should receive adequate iron supplementation beginning no later than when epoetin alfa treatment starts and continuing throughout therapy. Patient may need vitamin B12 and folic acid . Monitor BP before therapy. Blood pressure may increase, especially when hematocrit increases in the early part of therapy. Monitor blood counts; elevated hematocrit may cause excessive clotting Inform patient that pain in limbs and long may occur after injection(usually within 2 hours.) Patient may need additional heparin to prevent clotting during dialysis treatment. Tell patient to monitor blood pressure at home and to adhere to dietary restrictions.

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DRUG GENERIC NAME: Pizotifen hydrogen maleate, Vitamin B complex, Nicotinamide BRAND NAME: Mosegor Vita DOSE: 1 tab ROUTE: P.O FREQUENCY: 0-0-1 lack of appetite associated w/ vitamin B deficiency secondary to impaired dietary intake or absorption A coenzyme that stimulate metabolic function and is needed for cell replication, hematopoiesis, nucleoprotein and myelin synthesis. INDICATION ACTION ADVERSE REACTION CNS: asthenia, dizziness, fatigue, headache, paresthesia, seizures. CV: edema, hypertension, increased clotting of arteriovenous grafts. GI: abdominal pain and constipation (in children) diarrhea, nausea, vomiting. MUSCKULOSKELETAL: arthralgia RESPIRATORY: cough, shortness of breath. SKIN: infection site reactions, rash, urticaria. CONTRAINDICATIONS Contraindicated in patient hypersensitivity to products derived from mammal cells or albumin (human) and in those with uncontrolled hypertension. NURSING CONSIDERATIONS Obtain sensitivity test history before administration Avoid IV administration because faster systemic elimination will reduce the effectiveness of vitamin. Dont give large doses of vitamin B 12 routinely; drug is lost through excretion. Monitor patient for hypokalemia for first 48 hours, as anemia corrects itself. Give potassium supplements as needed.