thrombopoietin receptor agonists
Treatment of thrombocytopenia in patients with chronic liver disease who are scheduled to undergo a medical or dental procedure.
Increases platelet production by initiating proliferation and differentiation of megakaryocytes from bone marrow progenitor cells.
Absorption: 66–69% absorbed following oral administration.
Distribution: Widely distributed to tissues.
Protein Binding: >96%.
Metabolism and Excretion: Primarily metabolized by CYP2C9 and CYP3A4 isoenzymes; primarily eliminated in feces (34% as unchanged drug).
Half-life: 19 hr.
TIME/ACTION PROFILE (effect on platelet count)
|PO||3–5 days||10–13 days||2 wk|
Use Cautiously in:
CNS: fatigue, headache
CV: THROMBOEMBOLISM, peripheral edema
F and E: hyponatremia
GI: abdominal pain, nausea
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
PO (Adults) Platelet count <40 x 109 /L– 60 mg once daily for 5 days (should be initiated 10–13 days prior to scheduled procedure; procedure should be performed 5–8 days after last dose); Platelet count 40–<50 x 109 /L– 40 mg once daily for 5 days (should be initiated 10–13 days prior to scheduled procedure; procedure should be performed 5–8 days after last dose.
Tablets: 20 mg
Lab Test Considerations:
Obtain platelet count before starting therapy and on day of procedure to make sure platelet count is adequate.
Decreased requirement for platelet transfusions or rescue procedures for bleeding.
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