Transport Nutrients to and from tissue cells

The arteries carry oxygenated blood (blood that has received oxygen from the lungs) from the heart to the rest of the body.

The blood then travels through the veins back to the heart and lungs, where it receives more oxygen.

Cell full of hemoglobin Blood gets its bright red color when hemoglobin picks up oxygen in the lungs. As the blood travels through the body, the hemoglobin releases oxygen to the tissues.

These are colorless cells and possess a nucleus. They function in defending the body against pathogens. Lymphocytes agranulocytes - produce antibodies, the specific defence proteins. Made in bone marrow and lymphatic tissue.

Responsible for clotting of the blood Responsible for repair of damaged tissue releasing the hormone platelet growth factor.

Iron deficiency anemia. Anemia due to chronic disease. Anemia due to kidney disease. Autoimmune hemolytic anemia.

Neutropenia Human immunodeficiency virus (HIV) Leukemia

 Thrombocytopenia Hemophilia

 Thrombosis

of a clot.

is the formation

A thrombus may form in any vessel, artery, or vein when blood flow is impeded.

Anticoagulants are used to prevent the formation and extension of a thrombus (blood clot).

GENERIC NAME Anisindione ah-nis-in-dye-on

TRADE NAME Miradon

USES Prophylaxis and treatment of venous thrombosis and its extension; prevention and treatment of atrial fibrillation with embolization, prophylaxis and treatment of pulmonary embolism Venous thrombosis, atrial fibrillation with embolism, pulmonary embolism (PE), prophylaxis of systemic embolism after acute MI

ADVERSE REACTIONS Hemorrhage, nausea, alopecia, dermatitis, vomiting, anorexia, abdominal cramping, nausea,

Warfarin sodium

Coumadin, generic

Nausea, alopecia, hemorrhage, urticaria, dermatitis, vomiting, anorexia, abdominal cramping, priapism

GENERIC NAME heparin

TRADE NAME Generic

USES

ADVERSE REACTIONS Thrombosis/emboli Hemorrhage, sm, diagnosis and chills, fever, treatment of urticaria, local disseminated irritation, intravascular erythema, mild coagulation (DIC), pain, hematoma or prophylaxis of ulceration at the deep vein injection site (IM or thrombosis (DVT), SC), bruising clotting prevention

heparin sodium lock flush solution

Clearing intermittent infusion lines (heparin lock) to prevent clot formation at site

None significant

10,00020,000 units SC in divided doses q812h; 500010,000 units q46h intermittent IV; 500040,000 units/d IV infusion; 5000 units SC q2h before surgery and 5000 units SC after surgery q812h 10100 units/mL heparin solution

GENERIC NAME dalteparin sodium

TRADE NAME Fragmin

USES Unstable angina/non Qwave MI, DVT prophylaxis

Danaparoid sodium

Orgaran

Prophylaxis of DVT, after hip replacement surgery

ADVERSE REACTIONS Hemorrhage, bruising, thrombocytopenia, chills, fever, pain, erythema and irritation at site of injection Hemorrhage, bruising, thrombocytopenia, hyperkalemia, hypersensitivity, fever, pain and erythema at injection site

Angina/MI: 120 IU/kg, SC q12h with concurrent oral aspirin; DVT: 2500 IU SC daily

750 anti-Xa units BID SC

GENERIC NAME

TRADE NAME Lovenox

USES DVT and prophylaxis, DVT and pulmonary embolism (PE) treatment, unstable angina/nonQ-wave MI

Enoxaparin sodium

ADVERSE REACTIONS Hemorrhage, bruising, thrombo-cytopenia, hyperkalemia, hypersensitivity, fever, pain and erythema at injection site

Tinzaparin sodium

Innohep

Treatment of acute, symptomatic DVTwith or without pulmonary emboli when given with warfarin sodium

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; unstable angina, nonQ-wave MI: 1 mg/kg SC q12hANTICOAGULA NTS Hemorrhage, bruising, 175 anti-Xa IU/kg/d thrombo-cytopenia, SC once daily; 175 hyperkalemia, IU/kg/d SC once daily hypersensitivity, fever, until the patient has pain and erythema at been successfully injection site anticoagulated with warfarin

GENERIC NAME Phytonadione (vitamin K)

TRADE NAME Aqua-mephyton, Mephyton, generic

USES Prevention and treatment of hypoprothrombinemia associated with excessive doses of oral anticoagulants Acute management of heparin overdosage (neutralizes heparin)

ADVERSE REACTIONS Gastric upset, unusual taste, flushing, rash, urticaria, erythema, pain and/or swelling at injection site Dyspnea, bradycardia, hypotension, hypertension, bleeding, hypersensitivity reactions

may repeat PO in 1248 h PO, IM, 2.510 mg, or in 68 h after parenteral dose

Protamine sulfate

Dose is determined by amount of heparin in body and the time that has elapsed since the heparin was given; the longer the interval, the smaller the dose required. Adult and pediatric: 1mg IV neutralizes 90 USP units of heparin derived from lung tissue or 115 USP units of heparin derived from intestinal mucosa

Thrombolytics are a group of drugs used to dissolve certain types of blood clots and reopen blood vessels after they have been occluded.

GENERIC NAME alteplase, recombinant

TRADE NAME* USES Activase Acute myocardial infarction (AMI), acute ischemic stroke, pulmonary embolism (PE)

ADVERSE REACTIONS Bleeding (GU, gingival, retroperitoneal), and epistaxis, ecchymosis

DOSAGE RANGES AMI: total dose of 100 mg IV given as 60 mg 1st h, 20 mg 2nd h and 20 mg over 3rd h for patients < 65 kg, decrease dose to 1.25 mg/kg 10 plus 10 U double bolus IV over 2 min each with the 2nd bolus given 30 min after the 1st Lysis of coronary artery thrombosis, 20,000 IU directly into vein; PE, DVT, embolism: 250,000 IU IV over 30 min followed by 100,000 IU for 2472 h

reteplase, recombinant

Retavase

AMI

Bleeding (GI, GU, or at injection site), intracranial hemorrhage, anemia

streptokinase

Streptase

AMI, DVT, PE, embolism

Minor bleeding (superficial and surface) and major bleeding (internal and severe)

GENERIC NAME tenecteplase

TRADE NAME* TNKase

USES AMI

ADVERSE REACTIONS Bleeding (GI, GU, or at injection site), intracranial hemorrhage, anemia Minor bleeding (superficial and surface) and major bleeding (internal and severe)

DOSAGE RANGES Dosage based on weight, not to exceed 50 mg IV

urokinase

Abbokinase

PE, lysis of coronary artery thrombi, IV catheter clearance

PE: 4400 IU/kg IV over 10 min, followed by 4400 IU/kg/hr for 12 h; lysis of thrombi: 6000 IU/min IV for 2 h; IV catheter clearance: see packaged instructions

GENERIC NAME darbepoetin alfa

TRADE NAME* Aranesp

USES Anemia associated with chronic renal failure

ADVERSE REACTIONS Hypertension, hypotension, headache, diarrhea, vomiting, nausea, myalgia, infection, cardiac arrhythmias, cardiac arrest

DOSAGE RANGES 0.45 mcg/kg IV, SC weekly

epoetin alfa (Erythropoietin; (EPO)

Epogen, procrit

Anemia associated with chronic renal failure, anemia related to zidovudine therapy in HIV-infected patients, anemia in cancer patients receiving chemotherapy, anemia in patients who undergo elective nonvascular surgery surgery: 300 U/kg/d SC x 10 d before surgery, on day of surgery and 4 days after surgery

Hypertension, headache, Individualized dosage CRF tachycardia, nausea, vomiting, 50100 U/kg (3 times skin rashes, fever, skin reaction weekly IV or SC), at injection site maintenance based on HCT, generally 25 U/kg 3 times weekly; zidovudine-treated HIV infected patients: 100 U/kg 3 times weekly; cancer: 150 U/kg 3 times weekly;

GENERIC NAME

TRADE NAME*

USES Prevention and treatment of iron deficiency anemia

ADVERSE REACTIONS GI irritation, nausea, vomiting, constipation, diarrhea, allergic reactions

DOSAGE RANGES Daily requirements: males, 10 mg/d PO; females, 18 mg/d PO; during pregnancy and lactation, 3060 mg/d PO; replacement in deficiency states, 90300 mg/d (6 mg/kg/d) PO for 610 months Daily requirements: males, 10 mg/d PO; females, 18 mg/d PO; during pregnancy and lactation, 3060 mg/d PO; replacement in deficiency states, 90300 mg/d (6 mg/kg/d) PO for 610 months

ferrous fumarate
(33% elemental iron)

generic

Feostat,

ferrous gluconate (11.6% elemental iron)

Fergon, generic

Prevention and treatment of iron deficiency anemia

GI irritation, nausea, vomiting, constipation, diarrhea, allergic reactions

GENERIC NAME ferrous sulfate (20% elemental iron)

TRADE NAME* Feosol, Fer-In-Sol, generic

USES Prevention and treatment of iron eficiency anemia

ADVERSE REACTIONS GI irritation, nausea, vomiting, onstipation, diarrhea, allergic reactions

DOSAGE RANGES Daily requirements: males, 10 mg/d PO; females, 18 mg/d PO; during pregnancy and lactation, 3060 mg/d PO; replacement in deficiency states, 90300 mg/d (6 mg/kg/d) PO for 610 months Up to 1 mg/d PO, IM, IV, SC Dosage based on body weight and grams percent (g/dL) of hemoglobin IV, IM

folic acid

Folvite, generic DexFerrum, InFeD, Generic

Megaloblastic anemia due to deficiency of folic acid Iron deficiency anemia

Allergic sensitization

iron dextran

Anaphylactoid reactions, soreness and inflammation at injection site, chest pain, arthralgia, backache, convulsions, pruritus, abdominal pain, nausea, vomiting, dyspnea Hypotension, cramps, leg cramps, nausea, headache, vomiting, diarrhea, dizziness

iron sucrose

Venofer

Iron deficiency anemia

100 mg elemental iron slow IV or during dialysis session

GENERIC NAME Ieucovorin Calcium

TRADE NAME* Wellcovorin, generic

USES

ADVERSE REACTIONS

DOSAGE RANGES Megaloblastic anemia: 1 mg/d IM rescue after methotrexate therapy: 1215 g/m2 PO or parentearally then 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 125 mg of elemental iron IV over at least 10 min

Treatment of Allergic sensitization, megaloblastic urticaria, anaphylaxis anemia leucovorin rescue after high-dose methotrexate therapy in osteosarcoma

sodium ferric gluconate complex

Ferrlecit

Iron deficiency

Flushing, hypotension, syncope, tachycardia, dizziness, pruritus, dyspnea, conjunctivitis, hyperkalemia Mild diarrhea, itching, edema, anaphylaxis

vitamin B12 generic (cyanocobalamin)

B12 deficiencies as seen in pernicious anemia, GI pathology; also used when requirements for the vitamin are increased; Schillings test

Schillings test: 1001000 mcg/d x 2 wk, then 100-1000 mcg IM q mo