Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0001175 (AIDS)
 120,706 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The chemistry, pharmacology, pharmacokinetics, clinical uses and efficacy, adverse effects, drug interactions, dosage and administration, and formulary considerations of epoetin are described. Erythropoietin, a glycoprotein hormone primarily synthesized in the kidney, is the chief regulator of red blood cell production. Erythropoietin concentrations increase in response to a hypoxic state, resulting in increased red blood cell formation, accelerated hemoglobin production, and premature movement of reticulocytes into the circulation. The human gene responsible for the production of erythropoietin recently was cloned, and the recombinant product--epoetin--has been made available through mass production. The apparent volume of distribution of i.v. epoetin approximates the assumed plasma volume both in healthy volunteers and in patients with chronic renal failure. Little is known about the metabolism and route of elimination of epoetin and erythropoietin. Epoetin recently was approved by the FDA for treatment of anemia associated with chronic renal failure. Clinical trials in patients receiving hemodialysis or peritoneal dialysis and in predialysis patients with renal dysfunction demonstrate epoetin's efficacy. Other potential indications include augmentation of blood production in patients enrolled in autologous blood donation programs and treatment of anemias associated with rheumatoid arthritis, sickle cell disease, acquired immunodeficiency syndrome, cancer, and premature birth. The most frequent adverse effect associated with epoetin therapy is the worsening or development of hypertension. Other adverse effects include thrombocytosis, hyperkalemia, rise in serum urea concentration, iron deficiency, and flu-like symptoms. No drug interactions with epoetin have been reported in humans. The recommended starting epoetin dosage in patients with chronic renal failure is 50-100 IU/kg three times weekly. Epoetin is available only as an injection for i.v. or s.c. administration. Epoetin provides a new therapeutic approach to the treatment of anemia associated with chronic renal failure in hemodialysis, peritoneal dialysis, and predialysis patients. Benefits of epoetin therapy include reduced need for blood transfusions, the amelioration of anemic symptoms, and an improved quality of life.
 ...
PMID:Epoetin: human recombinant erythropoietin. 268 Feb 41

Epoetin (recombinant human erythropoietin) therapy for patients with AIDS may reduce the need for blood transfusion; however, it is expensive. We conducted a cost-effectiveness analysis of the use of epoetin for AIDS patients from a healthcare system perspective. We constructed a decision analysis model using probability, outcome and cost data from the literature and hospital sources. The incremental cost-effectiveness ratio was measured in dollars per unit of blood saved. In AIDS patients undergoing transfusion with serum epoetin concentrations less than or equal to 500 U/L treatment with epoetin cost $US1007 per unit of blood saved compared with treatment without epoetin. One-way sensitivity analysis revealed that the incremental cost-effectiveness ratio was sensitive to the efficacy and unit price of epoetin, but less sensitive to the current price cap determined by the distributor.
 ...
PMID:A cost-effectiveness analysis of epoetin usage for patients with AIDS. 1014 34

Therapy associated with treatment-related anemia continues to be of great concern for health care providers. Patient satisfaction, patient adherence, and growing insurance reimbursement concerns related to Epoetin alpha therapy for anemia initiated the development of a nursing-led process improvement team at New York University (NYU) Medical Center. Multiple patient groups were identified and treated for anemia with Epoetin alpha through the guide of a standardized pathway providing a convenient and effective treatment plan. The treatment delivery had to be consistent with institutional reimbursement requirements while avoiding significant cost to the patient. Patient populations diagnosed with HIV anemia, HIV oncology, presurgical anemia, and medically complex anemia can now receive appropriate ambulatory treatment. This article describes the formation of the "Epo-Depot" and the logistics involved to service these patients with anemia.
J Assoc Nurses AIDS Care
PMID:New York University Medical Center's pilot "Epo-Depot" program: a win-win for patients and health care. 1553 14