00 Blood Dyscrasias Flashcards
What are some unique symptoms of Anemia?
Glossitis (inflamed tongue). Koilonychias (thin, concave nails). Pica (craving/eating non-foods)
What are the normal ranges for Hemoglobin (Hgb)?
M: 13.5-18
F: 12-16
What are the normal ranges for Hematocrit (Hct)?
M: 37-49%
F: 36-46%
What is the normal range for Mean Corpuscular Volume (MCV)?
80-100mm3
What do the labs look like for Microcytic anemia and what’s the main cause?
Low Hgb/Hct and MCV < 80. Usually d/t lack of iron
What do the labs look like for Normocytic anemia and what’s the main cause?
Low Hgb/Hct and MCV: 80-100. Usually d/t blood loss
What do the labs look like for Macrocytic anemia and what’s the main cause?
Low Hgb/Hct and MCV > 100. Usually d/t a lack of B12
What is the main treatment for Microcytic Anemia?
Iron (IV and PO formulations available)
What are the elemental percentages in common PO iron products?
Fumarate (33%) > Sulfate (20%) > Gluconate (10%)
Which iron product is first line?
Ferrous Sulfate PO
What common DDIs are there with iron products?
Tetracyclines, Fluroquinolones, Levothyroxine, Mycophenolate, Levodopa. Separate all these by 2 hours
What is the generic name of Fer-In-Sol?
Ferrous Sulfate PO
What is the generic name of Ferretts or Hemocyte?
Ferrous Fumarate PO
What is the generic name of Fergon?
Ferrous Gluconate PO
What are the common ADRs to all IV iron?
Hypotension (infuse slowly), flushing, rash, and pain
Which IV iron product requires a test dose?
Iron Dextran requires a test dose d/t possibility of anaphylactic reaction
What is the generic name of Infed?
Iron Dextran (IV)
What is the generic name of DexFerrum?
Iron Dextran (IV)
What is the generic name of Ferrlecit?
Sodium Ferric Gluconate (IV)
What is the generic name of Venofer?
Iron Sucrose (IV)
What is a common ADR of blood transfusions for microcytic anemia?
Iron overload –> needs pharmacological management for serum levels > 300 mcg/dL
What are the two medications used for Iron Overload?
Desferal (Deferoxamine) - IV formulation. Exjade (Deferasirox) - PO formulation (make into PO suspension, DO NOT chew or swallow whole)
What is the generic name of Epogen?
Erythropoeietin (Short-acting formulation) - IV or SQ
What is the generic name of Procrit?
Erythropoeietin (Short-acting formulation) - IV or SQ
What is the generic name of Aranesp?
Darbopoetin (Long-acting formulation) - IV or SQ
When do you initiate and stop Erythropoeietin or Darbopoetin for CKD on HD and not on HD?
On HD: Initiate Hgb < 10, stop when Hgb 11+.
No HD: Initiate Hgb < 10, stop when Hgb 10+
What are the contraindications for Erythropoeietin or Darbopoetin?
Uncontrolled HTN
What are the ADRs with Erythropoeietin?
Thrombotic events (DVT/PE). Increased seizure risk. HTN. Edema. Bone pain
What are the ADRs with Darbopoetin?
Hyper or Hypotension. Chest pain
What is the BBW for Darbopoetin?
For CKD: targeting Hgb > 12 is associated with increased mortality and serious cardio events. For cancer anemia: increased mortality and tumor progression; increased risk of thrombotic event - DO NOT use when anticipated outcome is cure
What is the primary treatment for Macrocytic Anemia?
B12; folate
When would you use IV or PO treatment for Macrocytic Anemia?
IV: if there are neurological complications; cannot absorb/comply; severe deficiencies. PO: for maintenance therapy
What is the generic name of Cyanocobalamin?
B12 (pink-ish red in color)
When is Cyanocobalamin contraindicated?
Cobalt allergy
What is the generic name of Folate?
B9 (folic acid)
How is folate usually dosed?
OTC: 0.4-0.8mg tab once daily
Rx: 1mg tab once daily
What is the definition of neutropenia?
ANC < 500 cell/mm3
What is the generic name of Neupogen?
Filgrastim (G-CSF) - colony stimulating factor for neutropenia
What is the generic name of Neulasta?
Peg-Filgrastim - colony stimulating factor for neutropenia
What is the generic name of Leukine?
Sargramostim (GM-CSF) - colony stimulating factor for neutropenia
What is the main ADR seen with colony-stimulating factors for neutropenia?
BONE PAIN; fever, HTN, peripheral edema
What is the definition of Thrombocytopenia?
Platelet < 100,000/mm3
What is the generic name of Neumega?
Oprelvekin (thrombocytopenia treatment)
What is the generic name of Promacta?
Eltrombopag (thrombocytopenia treatment)
What is the generic name of NPLATE?
Romiplostim (thrombocytopenia treatment)
Which Thrombocytopenia Treatment Agent contains a BBW?
Neumega: Possible anaphylaxis
What is the Schilling Test used to diagnose?
Pernicious anemia
