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8/3/2019 Blood System Drugs
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Transport Nutrients to and from
tissue cells
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The arteries carry oxygenated blood (bloodthat has received oxygen from the lungs) fromthe heart to the rest of the body.
The blood then travels through the veins backto the heart and lungs, where it receives moreoxygen.
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Cell full of hemoglobin
Blood gets its bright red color whenhemoglobin picks up oxygen in thelungs.
As the blood travels through the body,the hemoglobin releases oxygen to thetissues.
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These are colorless cells and possess a nucleus.
They function in defending the body against
pathogens.
Lymphocytes agranulocytes - produceantibodies, the specific defence proteins.
Made in bone marrow and lymphatic tissue.
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Responsible for clotting of the blood
Responsible for repair of damaged tissue releasing the hormone platelet growthfactor.
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Iron deficiency anemia.
Anemia due to chronic disease. Anemia due to kidney disease.
Autoimmune hemolytic anemia.
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Neutropenia
Human immunodeficiencyvirus (HIV)
Leukemia
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Thrombocytopenia
Hemophilia
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Thrombosis is the formationof a clot.
A thrombus may form in any vessel,artery, or vein when blood flow isimpeded.
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Anticoagulants are used to prevent theformation and extension of a thrombus (bloodclot).
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GENERIC NAME TRADE NAME USES ADVERSEREACTIONS
Anisindioneah-nis-in-dye-on
Miradon Prophylaxis andtreatment of venous
thrombosis and its
extension; preventionand treatment ofatrial fibrillation with
embolization,prophylaxis andtreatment ofpulmonary embolism
Hemorrhage, nausea,
alopecia, dermatitis,
vomiting, anorexia,
abdominal cramping,
nausea,
Warfarin sodium Coumadin, generic Venous thrombosis,atrial fibrillation with
embolism, pulmonary
embolism (PE),prophylaxis ofsystemic embolismafter acute MI
Nausea, alopecia,
hemorrhage, urticaria,
dermatitis, vomiting,
anorexia, abdominalcramping, priapism
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GENERIC NAME
TRADE NAME
USES
ADVERSEREACTIONS
heparin Generic Thrombosis/embolism, diagnosis and
treatment of
disseminated
intravascular
coagulation (DIC),
prophylaxis of
deep vein
thrombosis (DVT),
clotting prevention
Hemorrhage,
chills, fever,
urticaria, local
irritation,
erythema, mild
pain, hematoma or
ulceration at the
injection site (IM or
SC), bruising
10,00020,000
units SC in divided
doses q812h;
500010,000 units
q46h intermittent
IV; 5000
40,000
units/d IV
infusion; 5000
unitsSC q2h before
surgery and 5000
units SC aftersurgery q812h
heparin sodium
lock flush solutionClearing
intermittent
infusion lines
(heparin lock) to
prevent clotformation at site
None significant 10100 units/mLheparin solution
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GENERIC NAME TRADE NAME USES ADVERSEREACTIONS
dalteparin sodium Fragmin Unstableangina/non Q-
wave MI, DVT
prophylaxis
Hemorrhage,
bruising,
thrombocy-
topenia, chills,
fever, pain,erythema and
irritation at site of
injection
Angina/MI: 120
IU/kg, SC q12h
with concurrent
oral aspirin; DVT:
2500 IU SC daily
Danaparoid
sodiumOrgaran Prophylaxis of
DVT, after hip
replacement
surgery
Hemorrhage,
bruising, thrombo-
cytopenia,
hyperkalemia,
hypersensitivity,
fever, pain anderythema at
injection site
750 anti-Xa units
BID SC
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GENERIC NAME TRADE NAME USES ADVERSEREACTIONS
Enoxaparin sodiumLovenox DVT and prophylaxis,
DVT and pulmonary
embolism (PE)
treatment, unstable
angina/nonQ-wave
MI
Hemorrhage, bruising,
thrombo-cytopenia,
hyperkalemia,
hypersensitivity, fever,
pain and erythema at
injection site
DVT prophylaxis: 30
mg q12h SC or 40 mg
once daily SC; in
abdominal surgery for
patients at risk for
thromboembolic
complications: 40
mg/d SC;DVT/PE treatment:1 mg/kg SC q12h;unstableangina, nonQ-wave
MI:1 mg/kg SC
q12hANTICOAGULA
NTSTinzaparin sodium Innohep Treatment of acute,
symptomatic DVTwith
or without pulmonary
emboli when given
with warfarin sodium
Hemorrhage, bruising,thrombo-cytopenia,
hyperkalemia,
hypersensitivity, fever,
pain and erythema at
injection site
175 anti-Xa IU/kg/dSC once daily; 175
IU/kg/d SC once daily
until the patient has
been successfully
anticoagulated with
warfarin
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GENERIC NAME TRADE NAME USES ADVERSEREACTIONS
Phytonadione
(vitamin K)Aqua-mephyton,
Mephyton, genericPrevention and
treatment of hypopro-
thrombinemia
associated with
excessivedoses of oralanticoagulants
Gastric upset,
unusual taste,
flushing, rash,
urticaria, erythema,
pain and/or swelling
at injection site
may repeat PO in
1248 h PO, IM,
2.5
10 mg, or in 6
8
h after parenteral
dose
Protamine sulfateAcute management of
heparin overdosage
(neutralizes heparin)
Dyspnea,
bradycardia,
hypotension,hypertension,
bleeding,
hypersensitivity
reactions
Dose is determined
by amount of heparin
in body and the timethat has elapsed
since the heparin was
given; the longerthe interval, the
smaller thedose required.Adult and pediatric:
1mg IVneutralizes 90 USP
units ofheparin derived from
lungtissue or 115 USP
units ofheparin derived fromintestinal mucosa
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Thrombolytics are a group of drugsused to dissolve certain types of
blood clots and reopen blood vesselsafter they have been occluded.
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GENERIC NAME TRADE NAME* USES ADVERSE REACTIONS DOSAGE RANGES
alteplase, Activase Acute myocardial Bleeding (GU, gingival, AMI: total dose of 100 mg
recombinant infarction (AMI), retroperitoneal), and IV given as 60 mg
acute ischemic epistaxis, ecchymosis 1st h, 20 mg 2nd h
stroke, pulmonary and 20 mg over 3rd h
embolism (PE) for patients < 65 kg,
decrease dose to
1.25 mg/kg
reteplase, Retavase AMI Bleeding (GI, GU, or at injection 10 plus 10 U double bolus
recombinant site), intracranial hemorrhage, IV over 2 min each with the
anemia 2nd bolus given 30 min
after the 1st
streptokinase Streptase AMI, DVT, PE, Minor bleeding (superficial and Lysis of coronary arteryembolism surface) and major bleeding thrombosis, 20,000
(internal and severe) IU directly into vein;
PE, DVT, embolism:
250,000 IU IV
over 30 min followed by
100,000 IU for 2472 h
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GENERIC NAME TRADE NAME* USES ADVERSE REACTIONS DOSAGE RANGES
tenecteplase TNKase AMI Bleeding (GI, GU, or at injection Dosage based on weight,site), intracranial hemorrhage, not to exceed 50 mg IV
anemia
urokinase Abbokinase PE, lysis of coronary Minor bleeding (superficial and PE: 4400 IU/kg IV
artery thrombi, IV surface) and major bleeding over 10 min, followed by
catheter clearance (internal and severe) 4400 IU/kg/hr for 12 h;
lysis of thrombi: 6000IU/min IV for 2 h; IV
catheter clearance: see
packaged instructions
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GENERIC NAME TRADE NAME* USES ADVERSE REACTIONS DOSAGE RANGES
darbepoetin alfa Aranesp Anemia associated Hypertension, hypotension, 0.45 mcg/kgwith chronic headache, diarrhea, vomiting, IV, SC weeklyrenal failure nausea, myalgia, infection,
cardiac arrhythmias, cardiacarrest
epoetin alfa Epogen, Anemia associated Hypertension, headache, Individualized dosage CRF
(Erythropoietin; procrit with chronic renal tachycardia, nausea, vomiting, 50100 U/kg (3 times(EPO) failure, anemia related skin rashes, fever, skin reaction weekly IV or SC),
to zidovudine therapy at injection site maintenance based onin HIV-infected patients, HCT, generally 25 U/kg
anemia in cancer 3 times weekly;patients receiving zidovudine-treated HIV
chemotherapy, infected patients: 100anemia in patients who U/kg 3 times weekly;
undergo elective cancer: 150 U/kg 3nonvascular surgery times weekly;surgery: 300 U/kg/d
SC x 10 d beforesurgery, on day ofsurgery and 4 days
after surgery
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GENERIC NAME TRADE NAME* USES ADVERSE REACTIONS DOSAGE RANGES
ferrous fumarate Feostat, Prevention and GI irritation, nausea, vomiting, Daily requirements:
(33% elemental generic treatment of iron constipation, diarrhea, males, 10 mg/d PO;iron) deficiency anemia allergic reactions females, 18 mg/d PO;
during pregnancy andlactation, 3060 mg/dPO; replacement indeficiency states,90300 mg/d(6 mg/kg/d) POfor 610 months
ferrous gluconate Fergon, Prevention and GI irritation, nausea, vomiting, Daily requirements:(11.6% elemental generic treatment of iron constipation, diarrhea, males, 10 mg/d PO;iron) deficiency anemia allergic reactions females, 18 mg/d PO;
during pregnancy andlactation, 3060 mg/dPO; replacement indeficiency states,
90300 mg/d(6 mg/kg/d) POfor 610 months
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GENERIC NAME TRADE NAME* USES ADVERSE REACTIONS DOSAGE RANGES
ferrous sulfate Feosol, Prevention and GI irritation, nausea, vomiting, Daily requirements:(20% elemental Fer-In-Sol, treatment of iron onstipation, diarrhea, males, 10 mg/d PO;iron) generic eficiency anemia allergic reactions females, 18 mg/d PO;
during pregnancy andlactation, 3060 mg/dPO; replacement indeficiency states,90300 mg/d(6 mg/kg/d) POfor 610 months
folic acid Folvite, Megaloblastic anemia Allergic sensitization Up to 1 mg/dgeneric due to deficiency of PO, IM, IV, SCfolic acid
iron dextran DexFerrum, Iron deficiency Anaphylactoid reactions, Dosage based on bodyInFeD, anemia soreness and inflammation weight and gramsGeneric at injection site, chest pain, percent (g/dL) of
arthralgia, backache, hemoglobin IV, IMconvulsions, pruritus,
abdominal pain, nausea,vomiting, dyspnea
iron sucrose Venofer Iron deficiency Hypotension, cramps, leg 100 mg elemental ironanemia cramps, nausea, headache, slow IV or during
vomiting, diarrhea, dizziness dialysis session
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GENERIC NAME TRADE NAME* USES ADVERSE REACTIONS DOSAGE RANGES
Ieucovorin Wellcovorin, Treatment of Allergic sensitization, Megaloblastic anemia:
Calcium generic megaloblastic urticaria, anaphylaxis 1 mg/d IM rescue after
anemia leucovorin methotrexate therapy:
rescue after high-dose 1215 g/m2 PO
methotrexate therapy or parentearally then
in osteosarcoma 10 mg/m2 q6h for 72 h;
check serum creatinine
after 24 h; if 50% greater
than the pretreatment
level, increase Ieucovorin
dose to 100 mg/m2 until
serum methotrexate level
is 15 _ 10-8 M
sodium ferric Ferrlecit Iron deficiency Flushing, hypotension, 125 mg of elemental iron
gluconate syncope, tachycardia, IV over at least
complex dizziness, pruritus, dyspnea, 10 min
conjunctivitis, hyperkalemia
vitamin B12 generic B12 deficiencies as seen Mild diarrhea, itching, Schillings test:
(cyanocobalamin) in pernicious anemia, edema, anaphylaxis 1001000 mcg/d x
GI pathology; also 2 wk, then 100-1000
used when mcg IM q mo
requirements for the
vitamin are increased;
Schillings test