Epoetin (Epogen) Nursing Considerations

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Outline

 

Generic Name

  • Epoetin

Trade/Brand Name

  • Epogen

Therapeutic Class

  • Antianemic

Pharmacologic Class

  • Hormones

Mechanism of Action

  • Stimulates erythropoiesis (production of RBCs)

Indication

  • Anemia

Side Effects

  • Headache

  • Joint/muscle pain

  • Diarrhea

  • Cold symptoms

Nursing Considerations

  • Assess dialysis shunts

  • Contraindicated in albumin hypersensitivity

  • May cause

    • Seizures

    • CHF

    • MI

    • CVA

    • Hypertension

  • Do not shake vial

  • Initiate seizure precautions

  • Monitor

    • Bleeding times

    • Signs of anemia

Patient Education

  • Monitor blood pressure during therapy

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Transcript

Okay, let’s talk about Epoetin. Also known as Epogen. This is an IV injectable medication, as you can see our label for Epogen. So when we talk about the therapeutic class of a drug, we are talking about how the drug works in the body while the pharmacologic class of the drug is the chemical effect. So the therapeutic class of Epoetin is an antianemic while the pharmacologic class is a hormone, Epoetin works by stimulating the production of red blood cells or erythropoiesis, which is why it is indicated for anemia, particularly in patients with chronic kidney disease. So the side effects that we see with Epoetin are things like headache or body aches, joint and muscle pain and diarrhea, and sometimes cold symptoms, stuffy, nose, sneezing, sore throat, things like that. 

Okay. So a few nursing considerations for Epoetin. Remember this medication is often used on patients with severe kidney disease. So if dialysis shunt is present, make sure you are assessing it. Make sure to monitor the bleeding times of your patient, including their PTT and INR and just assess for monitor for anemia in general, Epoetin is contraindicated in patients with an albumin hypersensitivity. Epoetin may cause CHF exacerbations, seizures, myocardial infarction, CVA, and hypertension. Be sure to teach the patient to monitor their blood pressure during therapy. If you are administering Epoetin from a vial and not a prefilled syringe, do not shake the vial as the protein can become de-natured. A rare side effect that can occur is an issue called pure red cell aplasia, which is the development of antibodies against Epoetin molecule with a sudden and severe decline in hemoglobin and reticulocyte counts. It is unknown how it develops, and the onset is usually six to eight months after starting Epoetin. And the diagnosis is actually made by detection of antibodies with a bone marrow biopsy. So treatment of pure red cell aplasia involves immunosuppressant therapy for usually around three months until antibodies are no longer detected. So guys, if a patient is diagnosed with pure red aplasia, they should never receive Epoetin treatment again. That’s it for Epoetin or Epogen. Now go out and be your best self today. And as always happy nursing.

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