Agents Used In Anemias Flashcards
What are the symptoms of anemia?
Fatigue Tachycardia Shortness of breath Pale skin Dizziness Insomnia
Where is iron stored?
In intestinal mucosal cells, liver, spleen and bone marrow as ferritin
What is iron stored as?
Ferritin
What is the usual cause of iron deficiency anemia?
Acute/chronic blood loss
Insufficient intake
Heavy menstruation
Pregnancy
What are the typical lab findings in iron deficiency anemia?
Hypochromic, microcytic RBCs
High transferrin
Low ferritin level
What are the different types of oral preparations that can be used in iron deficiency anemia?
Preparations containing ionic iron
Complex iron preparations
What are the oral preparations containing ionic iron?
Ferrous sulfate
Ferrous fumarate
Ferrous gluconate
What are the complex iron preparations?
Fe(III)-hydroxide-polymaltose
What is the duration of treatment for iron deficiency anemia?
2-6 months
What are the interactions of the agents used in iron deficiency anemia?
With chelate forming compounds
What are the adverse effects of the oral preparations used in the treatment of iron deficiency anemia?
GI symptoms - nausea, abdominal pain, constipation
What are the parenteral preparations used in iron deficiency anemia?
Iron dextran
Sodium ferric gluconate complex
Iron-sucrose complex
NEVER FERROUS!
What are the clinical indications of using parenteral preparations in the treatment of iron deficiency anemia?
Severe absorption insufficiency
Very marked bleeding
How are the parenteral preparations for the treatment of iron deficiency anemia administered?
IV bolus (slow) or infusion
What are the adverse effects of the parenteral preparations in the treatment of iron deficiency anemia?
Anaphylactic shock
What are the contraindications of using parenteral preparations in the treatment of iron deficiency anemia?
Hemosiderosis
Hemochromatosis
Acute hepatic problems
Non-iron-deficient-anemia
What is the active form of Vitamin B12?
Methylcobalamine
What are the causes of B12 deficiency?
Poor absorption (due to lack of IF: pernicious anemia) Low dietary levels
What are the other names of Vit B12?
Cyanocobalamine
Hydroxocobalamine
What are the clinical indications of cyanocobalamine administration?
B12 deficiency anemia Megaloblastic anemia Neuropathy of diabetic and alcoholic patients Spinal cord syndrome Facial paresis Herpes zoster Bariatric surgery
How is Vit B12 absorbed?
Absorption with IF
Where is cyanocobalamine stored?
In the liver
How is Vit B12 administered?
Oral
Parenteral (hydroxocobalamine)
What are the side effects of Vit B12 administration?
Allergic symptoms (around the site of administration)
Risk of embolism
Worsening of psoriasis, eczema
What are the contraindications of administering Vit B12?
Polycythemia
What is the other name for Vit B9?
Folic acid
What is the other name of folic acid?
Vit B9
What are the indications of folic acid supplementation?
Prevention and treatment of folic acid deficiency
Prevention of congenital neural tube defects
General usage is controversial (masks B12 deficiency)
What type of anemia is folic acid deficiency anemia?
Megaloblastic anemia
What can cause folic acid deficiency?
Increased demand (e.g., pregnancy and lactation)
Poor absorption
Alcoholism
Treatment with drugs that are dihydrofolate reducatase inhibitors (e.g., MTX, pyrimethamine, trimethoprim)
How is Vitamin B9 eliminated?
Urine and feces
How is folic acid administered?
Orally
What are the adverse effects of folic acid administration at high doses?
GI problems Sleep disturbances Depression Allergy Abundant availability can enhance the development of pre-cancerous and cancerous tumors
What are the contraindications of B9 supplementation?
Megaloblastic anaemia of unclarified origin
Folic acid dependent tumors (e.g., colon, hemopoietic)
