Epoetin Alpha and Filgrastim Overview

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Questions and Answers

What is the trade name for epoetin alpha?

Procrit (correct)

Leukine

Epogen (correct)

Neupogen

What classification does epoetin alpha fall under?

Hematopoietic growth factor

What are some side effects of epoetin alpha?

HTN, pure red cell aplasia, seizures, HA, fever, nausea, diarrhea, edema

What are important nursing considerations for administering epoetin alpha?

<ul> <li>SQ (preferred route), IV; Monitor patient's blood pressure; Not used in emergencies.</li> </ul> Signup and view all the answers

What is the trade name for filgrastim?

Neupogen Signup and view all the answers

What is the classification of filgrastim?

Colony-stimulating factor Signup and view all the answers

What is the mechanism of action of colony-stimulating factor?

Increases neutrophil production, maturation, and activation Signup and view all the answers

What is the trade name for pegfilgrastim?

Neulasta Signup and view all the answers

What are some side effects of filgrastim?

Bone pain, splenomegaly, fatigue, rash, epistaxis Signup and view all the answers

What are important nursing considerations for administering filgrastim?

<ul> <li>SQ route preferred; Not given until 24 hours after chemotherapy.</li> </ul> Signup and view all the answers

What is the trade name for sargramostim?

Leukine Signup and view all the answers

What classification does sargramostim fall under?

Colony stimulating factor Signup and view all the answers

What are some side effects of sargramostim?

Bone pain, respiratory distress Signup and view all the answers

What are important nursing considerations for administering sargramostim?

<ul> <li>SQ route preferred; Therapy initiated when ANC is < 500 cells/mm3.</li> </ul> Signup and view all the answers

What is the trade name for aldesleukin?

Proleukin Signup and view all the answers

What classification does aldesleukin fall under?

Immunostimulant-interleukin Signup and view all the answers

What is the mechanism of action for aldesleukin?

Promotes proliferation of B & T cells, macrophages, and NK cells. Signup and view all the answers

What are some side effects of aldesleukin?

Capillary leak syndrome, hypotension Signup and view all the answers

What are important nursing considerations for administering aldesleukin?

Monitor for lethargy; potential interactions with other drugs. Signup and view all the answers

What is the trade name for oprelvekin?

Neumega Signup and view all the answers

What classification does oprelvekin fall under?

Platelet enhancer/interleukin Signup and view all the answers

What is a side effect of oprelvekin?

Fluid overload Signup and view all the answers

What are important nursing considerations for oprelvekin?

Don't give before a chemo session; monitor for fluid overload. Signup and view all the answers

What is the trade name for interferon alpha 2a?

Roferon A Signup and view all the answers

What is the trade name for interferon beta 1a?

Avonex Signup and view all the answers

What is the classification of interferon?

Immunostimulant/Interferon, biologic response modifier Signup and view all the answers

What is the mechanism of action for interferon?

Non-specific inhibitor of viral replication and enhances immune function. Signup and view all the answers

Study Notes

Epoetin Alpha (Epogen, Procrit)

Trade names: Epogen, Procrit
Classification: Hematopoietic growth factor
Side effects: Hypertension (HTN), pure red cell aplasia, seizures (if blood pressure and hematocrit rise rapidly), headache, fever, nausea, diarrhea, edema, and a black box warning for increased risk of cardiovascular and thromboembolic events.
Nursing considerations: Preferred administration via subcutaneous (SQ) route, also intravenous (IV) possible. Overdose managed by phlebotomy. Monitor blood pressure; not designed for emergency use, effects may take 2-6 weeks to occur. Patients require iron supplementation and it is contraindicated in myeloid malignancies.

Filgrastim (Neupogen)

Trade name: Neupogen
Classification: Colony-stimulating factor
Mechanism of action: Stimulates production, maturation, and activation of neutrophils.
Side effects: Adverse effects include bone pain (sternum, ribs, pelvis), splenomegaly, high leukocyte count, fatigue, rash, epistaxis, decreased platelet count, fever, and nausea/vomiting.
Nursing considerations: Preferred SQ route. Administer at least 24 hours after chemotherapy. Discontinue if absolute neutrophil count (ANC) exceeds 10,000. Higher risk of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) in pediatric patients. Contraindicated in patients with hypersensitivity to E. coli, sickle cell disease, and myeloid cancer.

Pegfilgrastim (Neulasta)

Trade name: Neulasta
Nursing considerations: Long duration of action due to polyethylene glycol (PEG) modification. Administered for chemotherapy-induced neutropenia, given once per chemotherapy cycle, and not within 14 days before or 24 hours after chemotherapy.

Sargramostim (Leukine)

Trade name: Leukine
Classification: Colony stimulating factor
Side effects: May cause bone pain; first-time IV use can lead to respiratory distress.
Nursing considerations: Administer via SQ route. Therapy begins when ANC is less than 500 cells/mm³ until ANC reaches 1500 for three consecutive days. Discontinue if ANC exceeds 10,000 cells/mm³.

Aldesleukin (Proleukin)

Trade name: Proleukin
Classification: Immunostimulant (interleukin)
Mechanism of action: Promotes the proliferation of B and T cells, macrophages, and natural killer (NK) cells.
Side effects: Classified as toxic, arises capillary leak syndrome, hypotension, potential fatality.
Nursing considerations: Administered IV. Avoid use in lethargic patients as it may induce coma. Potential drug interactions with nearly all medications; dexamethasone may mitigate some toxicities from overdose.

Oprelvekin (Neumega)

Trade name: Neumega
Classification: Platelet enhancer (interleukin)
Side effects: Risk of fluid overload.
Nursing considerations: Avoid administration before chemotherapy sessions. Monitor for signs/symptoms of fluid overload, hypokalemia, dysrhythmias, and allergic reactions. Close monitoring recommended for children.

Interferon Alpha and Beta

Interferon alpha 2a trade name: Roferon A
Interferon alpha 2b trade name: Intron A
Interferon beta 1a trade name: Avonex
Classification: Immunostimulant/interferon, biologic response modifier.
Mechanism of action: Non-specific inhibition of viral replication, enhances immune function, suppresses cancer cell growth.
Interferon alpha 2b (Intron A) side effects: Flu-like symptoms, black box warning for aggravating neuropsychiatric, autoimmune, ischemic, or infectious disorders.
Interferon beta 1a (Avonex) side effects: Flu-like syndrome, mood changes, hepatotoxicity. Administered via intramuscular (IM) injection, indicated for multiple sclerosis (MS).

Cyclosporine (Sandimmune)

Trade name: Sandimmune
Classification: Immunosuppressant/calcineurin inhibitor.

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This quiz covers essential information about Epoetin Alpha (Epogen, Procrit) and Filgrastim (Neupogen), including their classifications, mechanisms of action, side effects, and nursing considerations. Test your knowledge on their uses and patient management strategies.