DRUG NAME MECHANISM INDICATION CONTRAINDICATION SIDE NURSING CONSIDERATION

OF ACTION EFFECTS/ADVERSE
EFFECTS
GENERIC NAME Stimulates Treatment of Hypersensitivity to SIDE EFFECTS BASELINE ASSESSMENT
epoetin alfa division, anemia in ots epoetin. Pure red cell Assess B/P before initiation (80% of pts with
differentiation of receiving or who aplasia, uncontrolled PTS receiving chronic renal failure have hstory of hypertension).
erythroid have received hypertension. Chemotherapy B/P often rises during early therapy in pts with
BRAND NAME progenitor cells in myelosuppressive Caution: History of history of hypertension. Consider that all pts
Epogen bone marrow. chemotherapy for seizures or controlled Frequent:Fever, eventually need supplemental iron therapy. Assess
a planned hypertension. diarrhea, nausea, serum iron (should be greater than 20%), serum
Therapeutic minimum of 2 vomiting, edema. ferritin (should be greater than 100 ng/ml) before
effect: Induces mos of and during therapy. Establish baseline BCB (esp.
AVAILABLE FORM erythropoiesis, chemotherapy; Occassional (13%- note Hct.)
Injection solution Epogen, Pocrit): 2,000 releases pts with chronic 11%): Asthenia,
units/ml, 3,000 units/ml, 4000 units/ml, reticulocytes from renal failure to shortness of breath, INTERVENTION/EVALUATION
10,000 units/ml, 20,000 units/ml, 40,000 the bone marrow. decrease need for paresthesia, skin Assess BCB routinely, (esp Hgb, Hct). Monitor
units/ml. RBC transfusion; reactions at aggressively for increased B/P (25% of pts require
HIV-infected pts administration site, antihypertensive therapy, dietary restrictions)>
on zidovudine asthenia, dizziness. Monitor temperature, esp, in cancer pts on
(AZT) therapy chemotherapy and zidovudine-treated HIV pts.
DOSAGES when endogenous PTS with HIV Monitor serum BUN, uric acid, creatinine,
erythropoietin Infection treated with phosphorus, potassium, esp, in chronic renal
SQ: ADULTS, ELDERLY: Initially, levels are 500 AZT failure pts.
150 units/kg 3 times/wk commony used mUnites/ml or
dose of 10,000 units 3 times/wk or less; pts Frequent(38%-15%):
40,000 units once wkly. scheduled for fever, fatigue,
elective headache, cough,
IV: CHILDREN 5 YRS AND OLDER: noncardiac, diarrhea, rash, nausea
600 units/kg once wkly. Maximum: nonvascular
40,000 units. surgery, reducing Occassional(14%-9%):
need for allogenic shortness of breath,
Increase dose: ADULTS, ELDERLY: blood asthenia, skin reaction
If Hgb does not increase by greater than transfusions at injection site,
1 g/dl and remains below 10g/dl after when dizziness.
initial 4 wks, may increase to 300 perioperative
units/kg 3 times/wk or 60,000 units once Hgb is greater ADVERSE
wkly. than 10 or less or EFFECTS
equal to 13 g/dl Hypertensive
Children: If Hgb does not increase by
and high risk for encephalopathy
 blood loss. thrombosis,
greater than 1 g/dl and remains less than cerebrovascular
10 g/dl after initial 4 wks once wkly OFF-LABEL: accident, MI, seizures
dosing, may increase dose to 900 Anemia in occur rarely.
units/kg/wk. Maximum: 60,000 units myelodysplastic hyperkalemia occurs
once wkly. syndromes. occasionally in pts
with chronic renal
Decrease dose: Decrease dose by 25% if failure, usually in
Hgb increases greater than 1 g/dl in any those who do not
2-wk period of Hgb level reaches level comply with
that will avoid red blood cell transfusion. medication regimen,
dietary guidelines,
frequency of dialysis
regimen.