17 Anti Anemics Flashcards
What is anemia?
Dec RBC
Dec hemoglobin in blood
Iron is important for ____
delivery of oxygen
Free iron is ___, so is functionally coordinated to ___
toxic
heme within hemoglobin
Under normal conditions a reserve of iron is stored?
bound to Ferritin
Increased rate of erythrocyte destruction?
Hemolysis
What is deficiency anemia?
Iron
B12
Folic Acid
What is hemolytic anemia?
RBC lysis defect
Sickle cell
What drugs are used as oral iron therapy?
Ferrous sulfate
Ferrous gluconate
Ferrous fumarate
If a pregnant woman needs iron supplements, what is recommended?
Oral Iron therapy
How long should treatment with oral iron be?
3-6 months
What are the adverse effects of oral iron therapy?
Nausea Heartburn Epigastric discomfort Abdominal cramps Constipation Diarrhea
What happens when oral iron therapy drugs interact with Antacids?
Inhibit absorption of ferrous compounds
What happens when oral iron therapy drugs interact with Ascorbic acid?
Increases the absorption of iron
What drug is given when OD on iron?
Deferoxamine
When do you use parenteral iron therapy?
Oral iron insufficient
Pregnant
When giving parenteral iron therapy, what do you need to monitor?
Dose dependent toxicity
What are adverse effects of parenteral iron therapy?
Acute hypersensitivity Anaphylactic shock Headache Malaise Fever Back pain Flushing Bronchospasm Nausea Vomit
What drugs are used for parenteral iron therapy?
Sodium ferric gluconate
Iron sucrose
Iron dextran
What drug is preferred for parenteral iron therapy?
Iron sucrose
Why is iron sucrose preferred for parenteral iron therapy?
Lower risk of anaphylactic reaction & better tolerated than iron dextran
How is iron dextran administered?
IM
IV
How is Iron dextran processed?
over several weeks
by macrophages to release iron from dextran complex
What is the safest treatment for B12 deficiency?
Oral
What drugs provide parenteral therapy for B12 deficiency?
Cyanocobalamin
Hydroxcobalamin
Adverse effects of this drug have been reported with IV route, so always give IM
Cyanocobalamin
What drug do I give a single dose for B12 deficiency?
Hydroxocobalamin
What is folic acid essential for?
Synthesis of
Amino acids
Purines
DNA
Who will have inadequate levels of folic acid in diet?
Alcoholic
Pregnant
What does folate deficiency result in?
Megaloblastic Anemia
Indistinguishable from B12 deficiency
How to distinguish the cause of anemia is not B12 deficiency?
Measure folate levels in serum & RBC
What drugs are used for antifolate cancer therapy?
Methotrexate
Trimethoprim
Pyrimethamine
What does a multivitamin containing folic acid reduce?
Fetal neural tube defects
What drug is effective to counter adverse effects of antifolate therapy in cancer?
Folinic acid
What is of value in the treatment of the anemia associated with renal failure?
Recombinant Erythropoietin
When giving erythropoietin what do you monitor?
Hemoglobin recovery
What is given to a pt with Thalessemia? Why?
Iron chelation therapy
Deferoxamine
Avoid end organ damage in heart, endocrine, liver
What drugs are used for sickle cell therapy?
Folate
Hydroxyurea
What kind of supplement is folate?
Lifetime
What does hydroxyurea do?
reactivates production of fetal hemoglobin
What is the most effective treatment for sickle cell disease?
Bone Marrow transplant
