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Filgrastim is a medication used to manage and treat neutropenia in patients with myelosuppression from chemotherapy or radiation, which increases the risk of infection and related events. This activity outlines the indications, actions, contraindication, adverse effects, and other important details of filgrastim as it pertains to members of the interprofessional team in clinical practice in the management of neutropenia and its clinical sequelae. Objectives: Identify the mechanism of action of filgrastim. Describe the potential adverse effects of filgrastim. Review the appropriate monitoring for patients who receive filgrastim. Outline interprofessional team strategies for improving care coordination and communication to advance filgrastim and improve outcomes. Access free multiple choice questions on this topic.

There is minimal data regarding the maximum tolerable dosage. Adverse effects that occur with filgrastim use mainly resolve following discontinuation of the drug. Some are manageable with supportive measures, e.g., bone pain, which is a common side effect usually managed with analgesics. Monitoring is essential to track response and minimize complications. Although rare(<5%), Leukocytosis with WBC >100,000/mm^3 has been observed in BMT patients with minimal adverse effects. The recommendation is to discontinue the drug if it occurs to prevent potential complications. There is no antidote for the reversal of filgrastim.

Filgrastim requires an interprofessional healthcare team approach, including clinicians, nurses, and pharmacists. Although it has uses in other fields of medicine, its primary use is in the field of hematology and oncology to reduce the duration of neutropenia in cancer patients undergoing chemotherapy or patients with myelosuppression. Clinicians should prioritize monitoring patients as monitoring is essential to track the response and minimize complications. Nurses should be aware of the proper method of drug administration and be alert to signs of infection and adverse effects. Pharmacists are also crucial for appropriate dosing schedules. The principal aim of filgrastim is to reduce the incidence of infection manifested by febrile neutropenia in patients receiving myelosuppressive chemotherapy. Thus, being alert to signs of infection would guide dosage and improve response outcomes in these patients. The interprofessional team approach will drive optimal patient results with the fewest adverse events in patients receiving filgrastim. [Level 5]