Erythropoietin

Snapshot

• A 60-year-old man with a history of human immunodeficiency virus (HIV) presents to his infectious disease doctor for fatigue. He has been on anti-retroviral therapy, including zidovudine. His lab monitoring has shown progressive decrease in his hemoglobin, requiring a blood transfusion once. As his HIV is stable, he does not wish to change his current treatment regimen. He was told there is a medication that would stimulate his bone marrow to produce more red blood cells.

Overview

• Drugs
  • epoetin alpha
    • recombinant human erythropoietin
      • erythropoietin is physiologically released by the kidney in response to hypoxia
• Mechanism of action 
  • stimulates red blood cell production by the bone marrow via activation of receptors on erythroid progenitor cells
• Clinical use
  • anemia of renal failure
  • bone marrow suppression
  • chemotherapy-induced anemia
  • drug-induced anemia
• Adverse effects
  • fever
  • nausea and vomiting
  • rash
  • pruritus
  • increased hematocrit leading to thrombosis
  • hypertension