[pagandeva2000]

I am told that patients taking this medication have to be monitored for severe elevation of blood pressure. I am trying to understand how this happens. I have not administered this medication myself, but but I was told that there is a policy in my clinic (one that I, of course, cannot find) that says that after administering this medication, the client must wait for 1/2 hour for nurse monitoring. My drug guide doesn't say anything about this, but speaks of hypertensive encephalopathy/hypertension. What is the reason of this increase in blood pressure?

Thanks!

[Sarah Kay]

I dose Epogen for chronic hemodialysis patients and have never heard of this happening. My first thought on this would be that kidney patients (if that is your population) already struggle with HTN and an increase in blood viscocity could affect vascular pressure over time as the Hgb/Hct increase.
I looked in my drug book and it stated that Epo does not have a direct vasopressor effect, but that BP may rise as Hct rises. It goes on to say that hypertensive encephalopothy and seizures have occurred in pts with chronic renal failure who are treated with Epo. However....I've been in renal for ~4 years and have never seen anything like that.

Hope this helps~
Sarah

[pagandeva2000]

Originally Posted by Sarah Kay

I dose Epogen for chronic hemodialysis patients and have never heard of this happening. My first thought on this would be that kidney patients (if that is your population) already struggle with HTN and an increase in blood viscocity could affect vascular pressure over time as the Hgb/Hct increase.
I looked in my drug book and it stated that Epo does not have a direct vasopressor effect, but that BP may rise as Hct rises. It goes on to say that hypertensive encephalopothy and seizures have occurred in pts with chronic renal failure who are treated with Epo. However....I've been in renal for ~4 years and have never seen anything like that.

Hope this helps~
Sarah

Yes, this actually helps a great deal! Just knowing that the viscocity of the blood may become increased actually brings the picture together for me. Thank you so much!

[bluefabian]

Second that. I've been administering epo for patients with BP as high as 180/100 with no visible effects so far - not that I don't care. These patients have already had their kidney failed due to HPT - witholding epo for reason of elevated BP will deprive them of this medication even if it is on the high region.

The leaflet tells of this too, but so far in practice I had no effects of it occuring (hopefully it stays that way).

[GLORIAmunchkin72]

My 2 cents: Could the increase in BP and viscosity be due to an overproduction of red blood cells?

[aegirl]

I used to administer epo on a regular basis. I was told it can temporarily raise the BP after receiving the shot. We had a protocol to ask the physician prior to administering if the BP was too high.

[SMK1]

why would viscosity increase immediately though? EPO stimulates production of rbc's which takes time...

[GLORIAmunchkin72]

I didn't know it was an immediate increase.

[SMK1]

Originally Posted by pagandeva2000

I am told that patients taking this medication have to be monitored for severe elevation of blood pressure. I am trying to understand how this happens. I have not administered this medication myself, but but I was told that there is a policy in my clinic (one that I, of course, cannot find) that says that after administering this medication, the client must wait for 1/2 hour for nurse monitoring. My drug guide doesn't say anything about this, but speaks of hypertensive encephalopathy/hypertension. What is the reason of this increase in blood pressure?

Thanks!

Gloria,
This is the part I was confused about.

[GLORIAmunchkin72]

I don't know either. I'll do a little research on this mystery.