...Epogen (Epoetin Alfa); Pharmacological Management and Therapeutic Implications [Name of the Writer] [Name of the Institution] Epogen (Epoitin Alfa); Pharmacological Management and Therapeutic Implications Abstract Anemia is the condition in which red blood cells (RBCs, also termed as erythrocytes) are not produced sufficiently to meet the need of normal body and thus not carrying sufficient amount of oxygen to the body tissues. Erythrocytes are abundantly produced in bone marrow by the process of erythropoesis, initiated by the hormone erythropoietin, found in kidney. Patients with renal failure are unable to produce enough erythropoietin to stimulate the erythropoesis process, resulting in lower production of erythrocytes (RBCs). Epogen (Epoetin alfa) is a special drug to stimulate the production of RBCs. This drug is made by the DNA recombinant technology with certain limitations and controlled dosage to the patients. In patients with Chronic Kidney Disease (CKD), HIV infected patients being treated by zidovudine and cancer patients being treated with chemotherapy, Epogen dosages are 50-100 units/kg thrice a week, 100 units/kg thrice a week and 600-900 units/kg thrice a week keeping an eye on hemoglobin level. Epoetin alfa (Epogen) injection is limited to use in certain conditions such as, if hemoglobin level rises to 11 g/dL ten Epogen is prohibited to administer. There are certain side effects of consuming Epogen ranging from local, gastrointestinal to dermatological...
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...What is Childhood Leukemia? Childhood Leukemia it is a form of leukemia, it’s usually (ALL) Acute Lymphocytic Leukemia, also it’s a cancer within ones childhood. Childhood leukemia’s cure rates are generally greater then there adult counterparts. With childhood leukemia treatments, some of the after effects of the treatment can last throughout ones adulthood. The Different Types of Leukemia. Leukemia, the types are grouped based on the plasma cell that’s affected. Leukemia, there is four different types to be considered. (CLL) Chronic Lymphocytic Leukemia: All the (lymphoid) cells are affected and they also grow slow do to the affection. This type accounts for the most of the leukemia’s found is personnel. People that are affected with this type of leukemia are those within the late ages. It is rarely ever found in children. (CML) Chronic Myeloid Leukemia: The (myeloid) cells are the one affected in this type and at first it grows slow then it picks up later on. This type also accounts for nearly a ¼ of new cases reported each year. Mainly affecting only adults. (ALL) Acute Lymphocytic (Lymphoblastic) Leukemia: Only the (lymphoid) cells are affected at a rapid rate and continue to grow quickly. This type also accounts for a ¼ of new cases of leukemia reported each year. This type is the main leukemia located in children at a young age. It may also affect adults to. (AML) Acute Myeloid Leukemia: Affects only (myeloid) cells only and grows rapidly...
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...peritoneum and spread to the ovary. The stages and treatment are the same for ovarian epithelial, fallopian tube, and primary peritoneal cancers. To my surprise, while researching the genetic link pertaining to ovarian cancer I found that 90% of all ovarian cancer is acquired by chance while 10% is inherited. Research has successfully identified three hereditary factors that predispose women to ovarian cancer: 1. Spontaneous new mutations in the tumor suppressor genes BRCA1 and BRCA2 2. Susceptibility to HNPCC also known as Lynch Syndrome II, a hereditary disease that puts individuals at risk for ovarian cancer. 3.Hereditary mutations in the BRCA1 gene or BRCA2 gene. There are three common treatment options for ovarian cancer. Surgery, chemotherapy and radiation therapy. Surgery for ovarian cancer has 2 main goals. The first goal is to see how far the cancer has spread from the ovary. Usually this means removing the uterus, along with both ovaries and fallopian tubes. The other important goal of surgery is to remove as much of the tumor as possible, this is called...
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...Aplastic anemia Definition Aplastic anemia is a condition where bone marrow does not produce sufficient new cells to replenish blood cells. The condition, per its name, involves both aplasia and anemia. Typically, anemia refers to low red blood cell counts, but aplastic anemia patients have lower counts of all three blood cell types: red blood cells, white blood cells, and platelets, termed pancytopenia. Causes Congenital or inherited causes Congenital or inherited causes of aplastic anemia (20%) include the following: • Patients usually have dysmorphic features or physical stigmata; on occasion, marrow failure may be the initial presenting feature. • Fanconi anemia • Dyskeratosis congenita • Cartilage-hair hypoplasia • Pearson syndrome • Amegakaryocytic thrombocytopenia (thrombocytopenia-absent radius [TAR] syndrome) • Shwachman-Diamond syndrome • Dubowitz syndrome • Diamond-Blackfan syndrome • Familial aplastic anemia Acquired causes Acquired causes of aplastic anemia (80%) include the following: • Idiopathic factors • Infectious causes, such as hepatitis viruses, Epstein-Barr virus (EBV), human immunodeficiency virus (HIV), parvovirus, and mycobacteria • Toxic exposure to radiation and chemicals, such as benzene • Transfusional GVHD • Orthotopic liver transplantation for fulminant hepatitis • Pregnancy • Eosinophilic fasciitis Drugs and elements, such as chloramphenicol, phenylbutazone, and gold, may cause aplasia of the marrow. ...
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...Advanced Pathophysiology Case Study 6 Case Study 6 Scenario: John is a 4 year-old boy who was admitted for chemotherapy following diagnosis of acute lymphoblastic leukemia (ALL). He had a white blood cell count of 250,000. Clinical presentation included loss of appetite, easily bruised, gum bleeding, and fatigue. Physical examination revealed marked splenomegaly, pale skin color, temperature of 102°F, and upper abdomen tenderness along with nonspecific arthralgia. Pathophysiology signs and symptoms The primary pathophysiological etiology for signs, symptoms and laboratory findings in 4 year-old John’s case study are secondary splenomegaly as a result of primary Acute Lymphoblastic Leukemia (ALL). Because of its proximity to the diaphragm, splenomegaly results in pain or fullness in the left upper abdomen (subsequent tenderness and loss of appetite) that may spread to the left shoulder (non-specific arthralgia). Splenomegaly may result in anemia (bruising, bleeding gums, decrease in pallor) fatigue and frequent infections (4 year old John’s WBC 250, 000 count and fever 102°F). However, in John’s case, some of the symptoms related to splenomegaly can also overlap with those of his diagnosis of ALL such as fever and abdominal distention. Additionally, anorexia, headache, seizures, lethargy, arthralgia, infection, and bruising are also potential side effects (Ghazi et al., 2010). Pathophysiology of acute lymphoblastic leukemia-AML comparison According to Gedaly...
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...Aplastic Anemia Aplastic anemia was discovered in 1888 by the physician Paul Ehrlich. Aplastic anemia is a condition that occurs when the body stops producing enough new blood cells due damaged bone marrow, and blood stem cells . Thus, "aplastic" refers to inability of the stem cells to generate the mature blood cells. In aplastic anemia, something either destroys the stem cells or drastically changes the environment of the bone marrow so that the stem cells can not develop properly. Some factors which can cause this problem are: exposure to radiation, chemotherapy, environmental toxins, anti-convulsive medications, certain viral infections, including viral hepatitis B, parvovirus B19, HIV and infectious mononucleosis , and autoimmune disease- where the body inappropriately attacks its own blood stem cells. Some people are more likely to develop aplastic anemia because of genetics. For example, Fanconi's anemia is an inherited condition that causes aplastic anemia and also physical abnormalities. Some women develop a mild form of aplastic anemia during pregnancy, but it tends to disappear after delivery. Aplastic anemia affects two to six of every 1 million people each year in the United States and Europe. Symptoms and Signs of aplastic anemia include: pallor, fatigue, weakness, dizziness, lightheadedness, rapid pulse, bruising of the skin, abnormal bleeding from the gums, nose, vagina or gastrointestinal tract...
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...suppress the production of normal blood cells, leading to anemia and other symptoms. Types of Leukemia Acute leukemia- is characterized by a rapid increase in the number of immature blood cells. Immediate treatment is required in acute leukemia because of the rapid progression and accumulation of the malignant cells, which then spill over into the bloodstream and spread to other organs of the body. Acute forms of leukemia are the most common forms of leukemia in children. Chronic leukemia- is characterized by the excessive buildup of relatively mature, but still abnormal, white blood cells. Typically taking months or years to progress, the cells are produced at a much higher rate than normal, resulting in many abnormal white blood cells. Whereas acute leukemia must be treated immediately, chronic forms are sometimes monitored for some time before treatment to ensure maximum effectiveness of therapy. Chronic leukemia mostly occurs in older people, but can occur in any age group. What are the causes of Leukemia? * previous chemotherapy or radiation therapy * exposure to high doses of radiation or to benzene (found in unleaded gasoline, tobacco smoke, chemical production facilities) * family history * genetic abnormality, such as an abnormality on chromosome 22 (also known as the Philadelphia chromosome) * genetic disorders, such as Down syndrome and Fanconi anemia What are the leukemia symptoms and sign? * Fevers ...
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...Anemia Statistics for Patient Populations To help explain the prevalence of anemia, the education kit provides statistics related to anemia of chronic disease and other at-risk patients. Older Adults & the Elderly Fatigue, weakness and other anemia symptoms can be misconstrued as normal signs of old age, but neither anemia nor these symptoms are a natural part of aging and should receive meticulous medical attention. · 10% of persons aged 65 and older have anemia1 · 50% of nursing home residents have anemia2 · Anemic elderly are twice as likely tbe hospitalized for falls3 Cancer Patients Cancer and its treatment can cause anemia by interfering with the body's production and regulation of red blood cells. · 80% of chemotherapy patients have severe anemia4-6 · 550,000 people die from cancer each year7 Chronic Kidney Disease Patients Anemia is a common and early complication of chronic kidney disease (CKD) and worsens as the disease progresses. An estimated 65 million American adults with hypertension8 and 17 million with diabetes9 are at increased risk for CKD and subsequently anemia. · 26 million Americans have chronic kidney disease10 · 28% of mild CKD patients are anemic11 · 87% of severe CKD patients are anemic11 Critically Ill Patients Many factors contribute tanemia in critically ill patients including trauma, surgical blood loss, inflammation and nutritional deficiencies. · 50% of patients in the intensive care unit are anemic12 · 75% of long-stay...
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...diet and what the resulting number of positive blood cultures for gram-negative rods would be among the participants using or not using the diet. This article was interesting to me because I did a case study on patient with severe aplastic anemia with resulting pancytopenia, who was also being administered the immune suppressant, Cyclosporine. This patient was severely immune compromised and part of his neutropenic precautions was a neutropenic diet. This diet was easy to provide while he was hospitalized but I was curious about when a patient is discharged do they still follow the strict diet? This article gave me some answers and some insight to my questions. This study of the effects of a neutropenic diet in outpatients was geared toward patients who had neutropenia, the study defines neutropenia as an “absolute neutrophil count (ANC) of less than 1,000/mm3” (DeMille, 2006). The study criteria required patients who were between the ages of 18 to 70 years old who would be starting their first chemotherapy session in an outpatient chemotherapy clinic. In addition to newly starting chemotherapy, the patients were also selected for their type of chemotherapy that had a high probability of resulting in neutropenia. and whose chemotherapy “did not require pretreatment with colony-stimulating factors or those used for cancers that usually...
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...Breakdown of Cancer Breakdown of Cancer Cancer is introduced when a single mutated cell begins to reproduce abnormally. According to Lee Copstead and Jacquelyn Banasik, cancer is a malignant neoplasm or new uncontrolled growth of invasive cells. Cancer begins when cells break from normal cell division that follows its own path. This is known as proliferation, which is abnormal cell division. According to (Copstead & Banasik, 2010) cancer develops when proto-oncogenes become inappropriately activated and this change is due to mutation in the cell’s (deoxyribonucleic acid) DNA. Furthermore, cancer is an out of control cell growth. For a patient to receive an accurate diagnosis of cancer a through history and physical examination has to be done. There are many tests necessary to diagnosis cancer. According to Copstead & Banasik, 2010) the definitive diagnosis of cancer is a positive cytological or histological result. Cytological is the microscopic finding of pathological cells. This can be done by aspiration or exfoliate. Whereas histological is the examination of cells by staining and examining sections of tissue. Other diagnostic tests, such as imaging, chest radiography, computed tomography (CT scan), mammography, or (positron emission tomography) PET scan. There are numerous laboratory test that can aid in the diagnosis of cancer. Urinalysis is used detect blood or hematuria that could be an indicator for bladder cancer. Tumor markers are substances...
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...hemoglobin in the red blood cells. Hemoglobin is an oxygen carrying protein in the red blood cells (Peterson, 2008). The abnormality of the hemoglobin is caused by a mutation in a gene of the hemoglobin protein. This abnormality hinders the proper formation globin genes of the hemoglobin molecules resulting in abnormal hemoglobin that may take the forms of “S” hemoglobin or “SC” hemoglobin or “beta-thalassemia” hemoglobin as noted by (Rees, Williams & Gladwin, 2010). Types of Sickle Cell Disease The disorders; sickle cell anemia disease (caused by “S” hemoglobin), “SC” disease (caused by “SC” hemoglobin and “S-beta thalassemia” (caused by “beta-thalassemia” hemoglobin) are collectively referred to as sickle cell disease (Rees et al, 2010). The most common form of Sickle cell disease is the Sickle cell anemia. Sickle beta-thalassemia is less common but can be either mild or severe while hemoglobin S-C disease is milder than Sickle cell anemia. Inheritance of Sickle...
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...cannot prevent leukemia but you can reduce your risks by reducing your intake of the risk factors. Detection Bone marrow aspiration, x-ray, CT scan, MRI, ultrasound, spinal tap How the cancer affects the body Since leukemia affects the blood throughout the body common symptoms will be anemia, bruising, recurrent infections (as your body can not heal properly), bone / joint pain, and difficulty breathing Treatment options Typical treatment options available are chemotherapy or radiation. Typically with leukemia, surgery does not take place. This is because leukemia is involved with the circulatory system which is located throughout the body making it difficult to operate on a specific area. Chemotherapy is medication that is used to kill the cancer cells in the body. Children can take chemotherapy like most adults can, intravenously (through an IV) or orally (by mouth). Depending on the severity of the disease will depend on the length of treatment. Each treatment will differ depending on the stage of cancer and how responsive they are to treatment. Radiation is commonly combined with the chemotherapy....
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...Cannabis indica, also known as marijuana, is a plant that is very commonly argued over and disputed. Marijuana has gained a presence in the world as a drug and is often used illegally through illegal use. Although the list of dangers of marijuana is quite high, marijuana can still be put to good use in the medical field. Many places, including several states in the United States, are proposing the decriminalization of marijuana for medical purposes. If used in the correct way, such as medical purposes, marijuana can be helpful to society in regards to disease and other complications of the human body. First of all, the use of medical marijuana can be used to treat and comfort patients diagnosed with cancer. In the entire world, cancer is the...
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...International Classification of Diseases Coding II Chapter 17 – 27 Chapter 17: 1. Which of the following anemias is caused by a failure of the bone marrow to produce red blood cells and may be congenital or acquired? A. Bone marrow deficiency anemia B. Sickle-cell anemia C. Aplastic anemia D. Thalassemia 2. Which of the following terms refers to either a reduction in the quantity of hemoglobin or a reduction in the volume of red blood cells? E. Anemia F. Coagulation defect G. Thrombocytopenia H. Leukocytosis 3. When a diagnostic statement of anemia is not qualified in any way, what should the coder do? I. Review the record for a surgical procedure; and if the patient had surgery, code as anemia due to acute blood loss. J. Review the medical record before assigning an unspecified type of anemia. K. Review the medical record to determine if the patient has been prescribed iron tablets, and code as iron-deficiency anemia. L. Review the medical record to determine if the patient has received chemotherapy, and assign the code for anemia due to antineoplastic chemotherapy. 4. Which of the following statements is true regarding a patient with documented sickle-cell trait? M. The patient has sickle-cell disease. N. Both of the patient’s parents carried the sickle-cell gene. O. The code for sickle-cell disease should be assigned. P. The patient received...
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...Cancer is a group of 200 or more diseases of controlled cell growth. The treatment of cancer can be very difficult process. Breast Cancer is most prevalent form of cancer among women and second leading cause of death. From a clinical standpoint radiation chemotherapy not only made strides in preventing the reoccurrence in cancer but also has some side effects that needed to be treated in order for a women to return to a healthy lifestyle. For example chemotherapy cause substantial weight loss, diaria, vomiting, anorexia and nausea after chemotherapy. The person may develop anemia, skin disorders, be sun sensitivity and become more vulnerable to every day common infections. The person will most likely lose their hair and substantially loss muscle tone and energy. Another fact about chemotherapy is along with killing cancer cells it may also kill healthy white blood cells that prevent common infections that lead to a weaker immune system. The person will need to take extra caution to avoid any kind of infections. They will also need to be washing their hands frequently, having excellent oral care, avoiding large crowds in areas with pore circulation, staying away from people with infection diseases and just the common cold. Thus returning to a healthy lifestyle will already be extremely challenging process for this person. Nutrition will be at the forefront at helping this person recover rapidly and prevent the reoccurrence of cancer. The person will need to have a relativity...
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