Pharmacotherapy for Hematologic Disorders Essay

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Introduction

The hematologic disorder is an umbrella term for a variety of blood-related diseases that affect red, white blood cells, proteins, and other components of blood. Anemia is a typical representative of this disorder group. It is defined as insufficiency or functional impairment of red blood cells. Hemoglobin levels are diverse for most patients but generally, diagnosis of anemia requires hemoglobin to be lower than 13.5 grams per deciliter in men, and 12 grams per deciliter in women (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Anemia may be a result of severe blood loss, nutrition issues, genetic susceptibility, cancer, or human immunodeficiency virus treatment. Sickle cell anemia surfaces mostly in African Americans and Hispanics. It threatens the lives of 100,000 people of total anemia cases in the U.S. only, which is why this paper is devoted to its drug therapy and management (Yawn et al., 2014).

Types of Drugs to Treat Symptoms of Sickle Cell Anemia

According to Arcangelo et al. (2017), a pharmacological cure for sickle cell anemia is presently absent. Drug therapy is, therefore, aimed at early prevention and symptom management. Pneumococcal conjugate vaccine or penicillin v potassium can be administered to infants aged two months. Penicillin intake may incur headaches, mild cases of diarrhea, or sore tongue (“Penicillin VK side effects in detail,” n.d.). Vaccination is reiterated twice after six to eight weeks since the last injection. Additionally, the vaccine is given shortly after the first birthday. At the age of two, a child is vaccinated with pneumococcal polysaccharide with a follow-up vaccination in three years. Subsequently, vaccinations are reiterated after a five-year period. Fever and headache are typical side effects of pneumococcal vaccines. Up to five years old, children can be administered 125-250 milligrams (depending on the actual age) of penicillin orally to prevent the occurrence of streptococcus-induced sepsis (Ndefo, Maxwell, Nguyen, & Chiobi, 2008).

1 milligram of folic acid is also advised to patients with sickle cell anemia on a daily basis (Arcangelo et al., 2017). Yet, evidence for its effect on the prevention of bone marrow aplasia and megaloblastic erythropoiesis is insufficient (Dixit et al., 2016). Hydroxyurea is used to manage pain and reduce the occurrence of crises. An optimal regimen for hydroxyurea has not yet been found. However, different researchers state that 10-15 milligrams per kilogram per day is an appropriate dosage (Arcangelo et al., 2017; Yawn et al., 2014; Ndefo et al., 2008). The dosage may be increased up to 35 milligrams per kilogram per day maximum depending on the reaction to treatment (Arcangelo et al., 2017). The treatment lasts six to eight weeks. Common side effects include fever, cough, back or side pain, etc.

Impact of Age on Effects of Prescribed Drugs

Age is important due to prevention effectiveness. Adults are less susceptible to a certain kind of vaccine (“Vaccine effectiveness – How well does the flu vaccine work?”, 2017). Therefore, children or infants with sickle cell anemia need to undergo preventive pharmacotherapy as early as possible. Age is also significant to detect the disorder as symptoms may affect life expectancy without proper treatment.

Measures to Reduce Negative Side Effects

Negative side effects of medications can be avoided or reduced by strict adherence to the regimen. In addition, pediatricians, physicians, and other health professionals should provide patients with adequate guidelines on medication use. The constant monitoring of blood count is suggested every two weeks to patients undergoing Hydroxyurea treatment (Ndefo et al., 2008).

Conclusion

Sickle cell anemia is an adverse disease that currently has no pharmacological cure. Drug therapy focuses on early prevention and pain management. Adherence to the treatment regimen and frequent blood count monitoring is paramount for its effectiveness. Age seems to be of significance for prevention medicine administration.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Dixit, R., Nettem, S., Madan, S. S., Soe, H. H. K., Abas, A. B., Vance, L. D., & Stover, P. J. (2016). Folate supplementation in people with sickle cell disease. The Cochrane Database of Systematic Reviews, 2, CD011130.

Ndefo, U. A., Maxwell, A. E., Nguyen, H., & Chiobi, T. L. (2008). Pharmacological management of sickle cell disease. Pharmacy and Therapeutics, 33(4), 238–243.

Penicillin VK side effects in detail. (n.d.). Web.

Vaccine effectiveness – How well does the flu vaccine work? (2017). Web.

Yawn, B. P., Buchanan, G. R., Afenyi-Annan, A. N., Ballas, S. K., Hassell, K. L., James, A. H., … John-Sowah, J. (2014). Management of sickle cell disease: Summary of the 2014 evidence-based report by expert panel members. JAMA, 312(10), 1033–1048.

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