Comprehensive Nursing Pharmacology Q 45
Currently, there is no way to prevent myelosuppression. However, there are medications available to elicit a more rapid bone marrow recovery. An example is:
A. epoetin alfa (Epogen, Procrit).
B. glucagon (Glucagen).
C. fenofibrate (Tricor).
D. lamotrigine (Lamictal).
Correct Answer: A. epoetin alfa (Epogen, Procrit).
Epoetin alfa (Epogen, Procrit) is a recombinant form of endogenous erythropoietin, a hematopoietic growth factor normally produced by the kidney that is used to induce red blood cell production in the bone marrow and reduce the need for blood transfusion.
Option B: Glucagon is a pancreatic alpha cell hormone, which causes glycogenolysis and gluconeogenesis. Glucagon is a polypeptide hormone commonly used in the treatment of severe hypoglycemia with FDA approval for the treatment of severe hypoglycemia and as a diagnostic aid in imaging of the GI tract. Glucagon binds G-coupled surface receptors found throughout the body in varying concentrations; binding to the glucagon receptors in the liver, GI tract, heart, pancreas, fat, adrenal glands, and kidneys activate adenylate cyclase which in turn raises cAMP levels. cAMP stimulates glycogenolysis and gluconeogenesis, resulting in the release of glucose, primarily from liver glycogen stores. The extrahepatic effects of glucagon are also mediated by adenylate cyclase, including relaxation of GI smooth muscle and positive inotropic effects.
Option C: Fenofibrate (Tricor) is an antihyperlipidemic agent that lowers plasma triglycerides. Fenofibrate is FDA approved for the management and treatment of hypertriglyceridemia, primary hypercholesterolemia or mixed dyslipidemia. It reduces low-density lipoprotein, triglycerides, and total cholesterol while increasing high-density lipoprotein cholesterol in adults. Fenofibrate should be used in conjunction with a restriction of cholesterol intake and exercise if lifestyle modifications alone have been insufficient.
Option D: Lamotrigine (Lamictal) is an anticonvulsant. Lamotrigine can be used to treat the following: partial seizures, primary generalized tonic-clonic seizures, bipolar depression, bipolar disorder type I maintenance), and Lennox-Gastaut syndrome. The mechanism of action for lamotrigine is not entirely understood. It is a triazine, and research has shown that lamotrigine selectively binds sodium channels, stabilizing presynaptic neuronal membranes and inhibiting glutamate release.