RUFAIDAH NURSING COLLEGE

PESHAWAR

Subject: Clinical Practicum

Topic: Drug Chart
Submitted By: Huma Zia
Class: POST RN 4th semester
Roll No: 1218
Submitted to: Ma’am Erum Ali
Date: 27/08 /2023

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 Anemia
A stroke, sometimes called a brain attack, occurs when something blocks blood supply to part of the
brain or when a blood vessel in the brain bursts.
The following drugs are used for Anemia
1. Alglucerase injection
2. Carbonyl iron (Abonyl)
3. Cyanocobalamin Vit B12 (Angel)
4. Darbepoetin Alfa ( Cresp)
5. Eculizumab
Drug No 1
Alglucerase injection

Ceredase (alglucerase) Injection is a manmade form of the enzyme β-glucocerebrosidase used as

an enzyme replacement in people with Type I Gaucher disease. Ceredase is not a cure for the condition.
The brand name Ceredase is discontinued, but generic versions may be available.

Generic name : Alglucerase

Brand name Ceredase
Dose
Children’s: 2.5 unites/kg
Adult: 2.5 unites/kg
Indication
 Alglucerase is a form of recombinant beta-glucocerebrosidase enzyme used to replace the deficient
endogenous enzyme in the treatment of Gaucher disease and Vit B12 deficiency.
Side Effects
 Abdominal discomfort.
 chills.
 nausea and vomiting.
 swelling at place of injection.

Contraindication
No Contraindication

Pharmacokinetics
The is rapidly absorbed in the upper gastrointestinal (GI) tract and results in a measurable inhibition of
platelet function within 60 minutes.
Pharmacodynamics
Gaucher disease is characterized by a functional deficiency in Beta-glucocerebrosidase enzymatic activity
and the resultant accumulation of lipid glucocerebroside in tissue macrophages which become engorged and
are termed Gaucher cells. Gaucher cells are typically found in liver, spleen and bone marrow. This can lead to
an enlarged spleen and liver (hepatosplenomegaly). Secondary hematologic sequelae include severe anemia
and thrombocytopenia. Injections of alglucerase into Gaucher disease patients leads to elevated serum levels
of the enzyme and reduction in the accumulation of glucocerebroside.

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 Drug No 2
Carbonyl iron Iron is a chemical element with the symbol Fe and atomic number 26. It is a metal that
belongs to the first transition series and group 8 of the periodic table. It is, by mass, the most common
element on Earth, just ahead of oxygen, forming much of Earth's outer and inner core.
Generic name: Carbonyl iron
Brand name : (Abonyl)
Dose
Children’s: 15 mg/kg/day
Adult: 15 mg/kg/day
Indication
Carbonyl iron is an iron replacement product. You normally get iron from the foods you eat. Iron helps your
body produce red blood cells that carry oxygen through your blood to tissues and organs. Carbonyl iron is
used to treat or prevent iron deficiency and iron deficiency anemia.
Side Effects
 diarrhea, constipation;
 nausea, vomiting, stomach pain;
 tooth discoloration; or.
 dark-colored bowel movements.

Contraindication
 hypersensitivity

Pharmacokinetics
Carbonyl reductase (secondary-alcohol:NADP(+) oxidoreductase, EC 1.1. 1.184) belongs to the family of short
chain dehydrogenases/reductases (SDR). Carbonyl reductases (CBRs) are NADPH-dependent, mostly
monomeric, cytosolic enzymes with broad substrate specificity for many endogenous and xenobiotic carbonyl
compounds. They catalyze the reduction of endogenous prostaglandins, steroids, and other aliphatic aldehydes
and ketones. They also reduce a wide variety of xenobiotic quinones derived from polycyclic aromatic
hydrocarbons. CBR reduces the anthracycline anticancer drugs, daunorubicin(dn) and doxorubicin (dox) to
their C-13 hydroxy metabolites, changing the pharmacological properties of these drugs. Emerging data on
CBRs over the last several years is generating new insights on the potential involvement of CBRs in a variety of
cellular and molecular reactions associated with drug metabolism, detoxication, drug resistance, mutagenesis,
and carcinogenesis.
Pharmacodynamics
Pharmacodynamics of carbonyl compounds can encompass a range of effects depending on the specific
compound and its interactions with biological systems. The presence of the carbonyl group in various
molecules contributes to their biological activities and functions in the body.

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 Drug No 3
Cyanocobalamin Vit B12 Cyanocobalamin is a form of vitamin B ₁₂ used to treat vitamin B ₁₂
deficiency except in the presence of cyanide toxicity. The deficiency may occur in pernicious anemia,
following surgical removal of the stomach, with fish tapeworm, or due to bowel cancer.

Generic name: Cyanocobalamin Vit B12

Brand name : (Angel)
Dose
Children’s: 1000 mcg IM/SC once daily
Adult: 1000 mcg IM/SC once daily
Indication
Cyanocobalamin is a manufactured version of vitamin B12. It's used to treat and prevent vitamin B12
deficiency anaemia (when you have low levels of this vitamin in your body). Your body requires vitamin
B12 to make red blood cells.
Side Effects
 Abdominal or stomach pain.
 bleeding from the gums or nose.
 blue lips and fingernails.
 coughing that sometimes produces a pink frothy sputum.
 decreased urine output.
 difficult, fast, noisy breathing, sometimes with wheezing.
 difficulty with swallowing.
 dilated neck veins.

Contraindication
 Hypersensitivity
Pharmacokinetics
Approximately 50 to 98% of the injected cyanocobalamin is present in the urine. A significant portion is
excreted within the first eight hours. About 3-8 mcg of cyanocobalamin is secreted into the GI tract daily
via the bile, and a majority is absorbed back.
Pharmacodynamics
Cyanocobalamin corrects vitamin B12 deficiency and improves the symptoms and laboratory
abnormalities associated with pernicious anemia (megaloblastic indices, gastrointestinal lesions, and
neurologic damage). This drug aids in growth, cell reproduction, hematopoiesis, nucleoprotein, and myelin
synthesis.

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 Drug No 4
Darbepoetin Alfa Darbepoetin alfa is a re-engineered form of erythropoietin containing 5 amino acid
changes resulting in the creation of 2 new sites for N-linked carbohydrate addition. It has a 3-fold
longer serum half-life compared to epoetin alpha and epoetin beta
Generic name: Darbepoetin Alfa
Brand name : ( Cresp)

Dose
Children’s: 6.25 mcg/week
Adult: 6.25 mcg/week
Indication
Darbepoetin may be used for patients on kidney dialysis or for those not on dialysis. Anemia can also
occur in people who are receiving chemotherapy to treat cancer. Darbepoetin alfa is used to treat severe
anemia in these patients. This medicine is available only with your doctor's prescription.
Side Effects
 Accumulation of pus.
 arm, back, or jaw pain.
 breathing problems (irregular, noisy, or trouble when resting)
 chest pain, discomfort, tightness, or heaviness.
 chills.
 cough producing mucus.
 decrease in the amount of urine.
 dilated neck veins.
Contraindication
Hypersensitivity
Pharmacokinetics
The pharmacokinetics of darbepoetin alfa was not dependent on dose or time. Mean hemoglobin values at
steady state were all approximately 11 g/dL, within the target range of 9.0 to 13.0 g/dL. Safety analyses
revealed no differences between darbepoetin alfa and epoetin.
Pharmacodynamics
Darbepoetin alfa is used in the treatment of anemia. It is involved in the regulation of erythrocyte
differentiation and the maintenance of a physiological level of circulating erythrocyte mass

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 Drug No 5
Eculizumab Eculizumab is a recombinant humanized monoclonal antibody used to reduce the risk of
hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome
(aHUS).
Generic name: Eculizumab
Brand name : E culizumab

Dose
Children’s: 250 mg IV qWeek for first 4 weeks
Adult: 600 mg IV qWeek for first 4 weeks
Indication
Eculizumab injection is used to treat paroxysmal nocturnal hemoglobinuria (PNH: a type of anemia in
which too many red blood cells are broken down in the body, so there are not enough healthy cells to bring
oxygen to all parts of the body).
Side Effects
 Back pain.
 black, tarry stools.
 bladder pain.
 blindness.
 bloody or cloudy urine.
 blurred vision.
 body aches or pain.
 burning or stinging of the skin.

Contraindication
Hypersensitivity to eculizumab, murine proteins, or any component of the formulation
Pharmacokinetics
A two-compartment population-pharmacokinetic model with first-order elimination best describes the
observed eculizumab pharmacokinetic profile following intravenous infusion in patients with anti-AChR
antibody-positive gMG. The model confirmed that eculizumab clearance is affected by body weight and
PLEX.
Pharmacodynamics
Eculizumab is a monoclonal antibody therapy designed to target and inhibit the complement protein C5.
By binding to C5, eculizumab prevents its cleavage into C5a and C5b, effectively blocking the formation
of the membrane attack complex (MAC) of the complement system. This prevents the complement-
mediated destruction of cells, particularly red blood cells, and helps manage conditions such as
paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS).
Inhibition of the MAC formation reduces hemolysis and tissue damage, leading to improved clinical
outcomes in patients with these disorders.
(The End)