Blood Products
These drugs are stimulants of different types of blood cells and are used to treat anaemia and leukopenia (often as a result of chemotherapy)
Packed Red Blood cells
This is made of isolated red blood cells produced from the centrifugation of whole blood.
Universal donor is O and the universal acceptor is AB
RBCs should be stored at 4oC prior to transfusion and it is transfused over 90-120 minutes
Used in patients that require repeated transfusions so as to avoid volume expansion with whole blood.
The transfusion threshold is 70g/L or 80g/L for those with ischaemic heart disease.
Fresh Frozen Plasma
This is a product made by centrifuging blood to collect the plasma portion.
It is made from a single unit of blood containing immunoglobulins, clotting factors and albumin.
Unlike the above, the universal donor of FFP is AB blood because the plasma doesn’t have any anti- A or anti-B antibodies and the universal acceptor is O.
Often used as bleeding prophylaxis before surgery to correct clotting in patients with liver failure.
Most suited for patients with a PT or APTT >1.5, typically given as 150-220mL
Cryoprecipitate
This is a blood product made from plasma usually transferred as a 6-unit pool
It contains: Factor VIII (100IU), Fibrinogen (250mg), von Willebrand factor + fibronectin
Volume is about 1/10th of FFP: 15-20ml
Usually used to replace fibrinogen e.g. after large transfusion, DIC, liver failure, before surgery.
Used to replace factor VIII e.g. von Willebrand Disease, Haemophilia A
Prothrombin Complex Concentrate (Beriplex)
This is composed of factor II, IX and X
It is used for emergency reversal of warfarin in patients with either major haemorrhage or head injury.
SAG-Mannitol Blood
This is where plasma in a blood unit is removed and replaced with the following components:
Sodium chloride, adenine, anhydrous glucose and Mannitol
This provides extended shelf life of RBCs and betters the transfusion as it is lower density.
Erythropoiesis-stimulating agents – Erythropoietin (EPO)
This is a glycoprotein which is released by the kidney and stimulates reticulocyte production
Synthesis is stimulated by hypoxia and it increases proliferation of RBC precursors and release into blood
It is used to treat anaemia in chemotherapy and anaemia in CKD.
Side effects
Hypertension
Seizures and headaches due to rapid expansion of blood volume.
Myeloid Growth factors
These are glycoproteins which are produced by many cells: fibroblasts, macrophages, immune cells
They act to stimulate proliferation and differentiation of cells in the myeloid lineage
Sagramostim(GM-CSF)
This is a recombinant protein which stimulates the macrophage pathway
It reduces neutropenia and infection in chemotherapy or bone marrow transplantation.
Side effects
Granulocytosis (increased WBC)
Bone pain
Filgrastim (G-CSF)
This is a recombinant protein which stimulates production of neutrophils
It reduces neutropenia and infection in chemotherapy or bone marrow transplantation.
Oprelvekin
This is a recombinant form of human interleukin-11, which stimulates cell proliferation.
It is used to prevent severe chemotherapy-induced thrombocytopenia and reduce the need for platelet transfusion following chemotherapy
Rather than stimulating new growth, the following drugs are used to directly deplete blood components.
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