18.01 Epoetin Alfa

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Overview

  1. Colony-stimulating factors
    1. Two types
      1. Epoetin Alfa
        1. Increases red blood cells
        2. Mechanism of action
          1. Epoetin Alfa acts like erythropoietin (a factor usually produced by the kidneys when RBC’s are low)
          2. Stimulates the bone marrow to produce RBC’s
        3.  Indications
          1. Anemia caused by Chronic Kidney Failure
          2. Patient with HIV
          3. Patients recieving chemotherapy
      2. Filigrastim and Sargramostim
        1. Increases white blood cells
      1.  

Nursing Points

General

  1. Epoetin Alfa is can be prescribed for patients who are anemic to help stimulate their RBC production.

Assessment

  1. Assess for side effects
    1. Headache
    2. High blood pressure
    3. Joint pain
    4. Blood clotts
      1. DVT- tenderness, redness, warmth of skin in arms or legs
      2. Pulmonary embolism – short of breath, cough that brings up blood
      3. Stroke- difficulty speaking, weakness numbness in arms or legs
    5. Skin rashes (if allergic)

Therapeutic Management

  1. Administration
    1. Given as IM SubQ injection
    2. Given weekly

Nursing Concepts

  1. Clotting
    1. Epoetin Alfa can increase a patients risk of blood clots forming.
  2. Pharmacology
    1. Epoetin Alfa is a medication that is prescribed to help increase a RBC’s

Patient Education

  1. Patients may be prescribed to give doses of Epoetin Alfa at home so will need to be educated on proper administration
  2. Patients should be informed to contact their doctor if their are any signs of having a blood clot.

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Video Transcript

So, in this video, we gonna cover the colony-stimulating factors. And, specifically, we gonna cover the Epoetin Alfa. So, there are two types of colony-stimulating factors; one is Epoetin Alfa and another one is Filigrastim and Sargramostim. This one is for RBCs, that means red blood cells. This one is for white blood cells. So whenever you give this one, Epoetin Alfa to patient, it increases the red blood cells count and this one is, are used for, use to increase the white blood cell counts.

Let’s talk a little bit more about the Epoetin Alfa. So, whenever in our body there’s a low red blood cells, what happens, is kidney is a really important organ, it senses the low red blood cells in our body and it releases what’s called erythropoietin. Now, this factor will go to the bone marrow and tell bone marrow “Hey, we have a low red blood cells. We need to produce more.” So, the bone marrow will produce more RBCs. Now, what happens if someone have chronic kidney disease (CKD)? What is someone has kidney failure? What if someone doesn’t have kidney at all? No kidney. What will happen? Kidney cannot, there’s no kidney, or kidney disease cannot sense the low red blood cells. Then, the bone marrow will not be able to produce more red blood cells. In that case, we give this Epoetin Alfa and Epoetin Alfa will stimulate the bone marrow instead of erythropoietin to increase the production of RBCs.

So, it’s basically given for patients who are chronic kidney patient and they have low red blood cells. Like for example, for the treatment of anemia. It could be associated with anything. The patient can get anemic if they have kidney problem or some other reasons as well. So, we need, we can use this epoetin alfa to increase the red blood cells count and for the treatment of anemia. Anemia caused by the Chronic Kidney failure, as we talked. And a patient with HIV and receiving anti viral medication. And the reason they didn’t give this medication for the patient who’s receiving anti-viral medication, is most of the antiviral medication will cause the low red blood cell production, that’s one of their side effects, and in order to overcome this side effect, the patient will be on Epoetin Alfa to increase their red blood cells. And also, in patients who’s receiving chemotherapy. The chemotherapy decreases the white cells count, red cells count, split list. So, to increase the red blood cells to a patient who’s receiving chemotherapy, they’ll be put them on, they’ll be receiving Epoetin alfa at the same time to maintain the red blood cells count.

Alright, and the side effects for this medication, Epoetin alfa is headache, high blood pressure, it can cause a joint pain, and skin rashes. Mostly skin rashes, because they are allergic to it, they have some kind of reaction to this medication. Mostly, this medication came as an injection either in IM or SUBQ and it’s given like every week. It’s not like a daily medication through the injection. In some video, sometimes they ask this questions in NCLEX. It’s truly a good drug to know, as well, if you’re working on some floor where they have, they’re doing like a kidney transplant, like that procedure and the patient will be on this medication very often. This is a short video about epoetin alfa.

If you have any questions about this medication, feel free to ask us and thanks for watching it. Thank you.

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Module 0 – Pharmacology Course Introduction

Module 3 – Disease Specific Medications

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