Hematopoietic Growth Factors

Definition: These products are used as supportive therapy in patients with some cancers of the blood.

Types: Erythropoetin (Epogen) and filgrastim (Neupogen).

Contraindications: Patients with cardiac problems should use caution when taking these medications.

Pharmacokinetics: Metabolized by the liver.

Side Effects: Hypertension, fluid retention, bone pain, and cardiac changes.

Nursing Care: When patients become neutropenic (WBC <10,000) these products are given to increase white blood cell production and increase immune support. Monitor labs daily. Use neutropenic precautions when caring for these patients.


Definition: These medications are used to prevent or inhibit bacterial growth that can lead to infections, or to treat existing infections.


  • • Penicillin: Amoxicillin (Amoxil), ampicillin (Principil), car- benicillin (Geocillin), and oxacillin (Bactocill).
  • • Aminoglycosides: Streptomycin, gentamicin, tobramycin, and neomycin.
  • • Sulfonamides: Trimethoprim/sulfamethoxazole.
  • • Cephalosporin: Cephalexin (Keflex), cefdinir (Omnicef), and ceftriaxone (Rocephin).
  • • Fluoroquinolone: Ciprofloxacin, levofloxacin, and gemifloxacin.
  • • Tetracycline: Doxycycline and minocycline.
  • • Macrolides: Azithromycin, erythromycin, and clarithromycin.

Contraindications: Obtain an allergy history before administering, and do not give if there has been a prior allergic response.

Pharmacokinetics: Given PO or IV; metabolized by the liver and excreted through the urine.

Side Effects: Headache, GI upset, hepatotoxicity, nephrotoxicity, allergic reactions, rash, and drowsiness. With sulfonamides, Stevens-Johnson's syndrome can be a side effect.

Nursing Care: Obtain an allergy history before administering. Monitor for side effects. Administer a probiotic to avoid complications such as C. diff. Monitor labs.

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