Haemophilia auto immune condition that attacks the platelets.

Haemophilia A is a genetic disorder when the clotting factors VIII and XI are partly or completely missing causing slow clotting of blood and increase risk of bleeding. Males are more likely to suffer from the disorder as it is in the X chromosomes. However women are the carriers of the disorder.  The main symptoms are bruising easily, nose bleeds, bleeding easily, bleeding gums. If the disorder isn’t treated then it can be serious and fatal. If bleeding starts and the blood isn’t clotting then the patient can bleed out. There is also a risk of bleeding inside of the brain. Symptoms to look out for are headaches, vomiting, stiff neck. Neutropenia is disorder when there is a low amount of white blood cells or neutrophils in the body, white blood cells are need to fight infections and without a high amount of them the body will be prone to infections. Filgrastim is a drug  used to stimulate the production of neutrophils. This is specialist use only. To be injected 5mcg/kg daily until count is within normal ranges, around 14 days. This is also administered to cancer patients before cytotoxic therapy. The most common side effects according to the BNF can include alopecia, anorexia, bone pain, chest pain, fever, GI distrurbances, headaches, injection site reactions, musculoskeletal pain and rashes. Some counselling points would be that the injection is only to be administered by a professional. If taken for more than 6 months it could effect the density of the bones so this must be monitored. EPO deficiency is a deficiency of erythropoietin which causes anemia. This effects patients going through kidney failure or cancer treatments. Darbepoetin alfa is an injection used subcutaneously 450 nanograms per kilo as a weekly dose intially then adjusted according to response. A maintinance dose is given once weekly or every two weeks. This injection helps to grow red blood cells which help to carry oxygen around the body. Side effects from the injection is pain at the site of injection and oedema which is a build up of fluid in the body causing swelling. The information I’ve collected is from the BNF and from the NHS website. ITP is an auto immune condition that attacks the platelets. Platelets bond together when the clotting process takes place. When there is a low platelet count the blood fails to clot. Symptoms can range from mild bruising to severe bleeding. It is a life long condition as there is no cure. Steroids are used to help treat the condition. This works be suppressing the immune system to that it stops attacking the platelets increasing the platelet count in the body. So prednisolone is prescribed and the dose as stated in the BNF is 1mg per kg daily and then gradually reduce the dose over several weeks. Side effects include abdominal distention, headaches, insomnia, water retention and weight gain. It is important that the dose is reduced gradually so the patient should never just stop taking prednisolone without speaking to their doctor. The dose should be taken all together for example 30mg is SIX 5mg tablets to be taken as a single dose. This should be taken in the morning after breakfast. Haemophilia A is a genetic condition that effects the clotting factors VIII. This causes very slow clotting of the blood. In severe case intravenous plasma concentrate VIII can be administered. Desmopressin is used to treat mild to moderate cases. According to the BNF a nasal spray can be used 300mcg every 12 hours when required, this is one spray in each nostril. To be administered when bleeding occurs or 30 minutes prior to any surgery. The dose can be repeated at intervals of at least 3 days.  This works by stimulating the clotting factor to help clot the blood and to reduce and eventually stop the bleeding. The main side effects are nausea, dizziness, sweating, fever, vomiting and diarrheoa and possible convulsions. The patient would need to be careful not take in too many fluids one hour before and eight hours after the dose is taken.