Anemia

Question 1

(erythropoetic) anemia mechanism of action

Answer 1

synthetic erythropoetin to trigger bone marrow to make RBCs for increased O2
d/t kidney dz

Question 2

RBC ingredients

Answer 2

1. iron
2. B12
3. hemogobin

Question 3

anemia med uses

Answer 3

chronic kidney dz
chemotherapy pt’s (w/o use for cure)
HIV pts taking zidovudine

Question 4

erythropoetic anemia meds

Answer 4

epoeitin alpha
darbepoetin - long acting “donut of sugar around epoeitin”

side effects:
HTN - must fix HTN prior & monitor
risk CV events
tumor progression

Question 5

HTN in relation to erythropoetic anemic meds

Answer 5

HTN must be addressed first & monitored throughout use

check Hgb levels - HOLD if Hgb>11 or HTN rises >1 gm/dL in 2 wks

Question 6

anemic iron deficiency meds

Answer 6

ferrous sulfate - PO, most common

iron dextran - IV

Question 7

iron deficiency

Answer 7

daily requirements:
primarily affects females
men = 8mg
women = 15-18mg
infants = 11

obtained in red meats, liver, egg yolks, yeast, grains, green leafy veggies, cooking in iron skillet

Question 8

issues w/ferrous sulfate

Answer 8

foods decrease absorption; take b/w meals w/OJ
nausea, constipation, dark green/melena
liquid form stains teeth; may take w/straw

Question 9

vitamin B12 deficiency med

Answer 9

cyanocobalamin

Question 10

B12 deficiency

Answer 10

nerve damage (parasthesia)
inactivated folic acid causes anemia

“pernicious anemia”: gradual, subtle onset anemia which eventually causes death
beefy red tongue

must give B12, not just folic acid, to address both issues
B12 found in dairy

Question 11

folic acid deficiency

Answer 11

essential to production of DNA, RBCs, platelets
caused by malabsorption and alcoholism

neural tube defects (spina bifida) d/t low levels during pregnancy

found in green leafy veggies
need 400-800mcg

Question 12

filgrastim

Answer 12

stimulates bone marrow to produce neutrophils
reduced risk of infection
bone pain (common), leukocytosis