Anemia Flashcards
__is the process of formation and development of new blood cells
hematopoiesis
begins with hematopoietic stem cells and requires an adequate supply of minerals and vitamins
__ is the process which produces new RBCs
erythropoiesis
controlled by feedback system involving the kidneys and bone marrow
Which type of iron is better absorbed, heme or non-heme?
heme
heme iron is about 3 times better absorbed
heme = ferrous = Fe2+ non-heme = ferric = Fe3+
Absorption of which type of iron is affected by other foods?
non-heme
ascorbic acid rich foods increase absorption
What is the only mechanism for excretion of excess iron?
blood loss
AES of iron intake:
heartburn nausea upper abdominal pain diarrhea constipation
As little as __ to _m grams of ferrous salts can cause death
1, 2
especially dangerous in young children
The bioavailability of iron ingested with food is __ to __ of that in a fasting pt?
1/3, 1/2
This is why we counsel to take iron on empty stomach
What is the new oral non salt iron replacement recently approved for iron deficiency?
ferric maltol (Accrufer)
What form of iron may be an option for pts intolerant of iron salts and prevents the need for IV iron therapy?
ferric maltol
Iron dextran has a BBW for what?
anaphylaxis
The erythropoietin receptors exist as ___ on the cell membrane
dimers
Erythropoietin receptors are a member of what family of proteins?
cytokine receptor
Erythropoietin stimulating agents (ESAs) may stimulate some types of __ cells
tumor
What may develop with erythropoietin stimulating agent (ESA) therapy?
iron deficiency
Which ESA is a recombinant human EPO that is nearly identical to endogenous hormone?
epoetin alfa
Epogen and Procrit
What is the plasma half life of epoetin alfa?
4-8 hours
Which ESA is genetically modified with four amino acid mutations that allow for additional carbohydrate side chains?
darbepoetin alfa
Aranesp
What is the plasma half life of darbepoetin alfa?
21 hours
A __ is a chemical complex of a metal ion and a multi dentate ligand
chelate
What does chronic blood transfusion therapy cause?
iron overload
can damage liver and heart
__ is a highly flexible, hexadentate iron chelator
deferoxamine (DFO)
What is the half life of deferoxamine?
20-30mins
how is deferoxamine dosed?
IV of subQ over 8-12 hours in a 24 hour period
5-7 days per week
Growth retardation, bone abnormalities, ophthalmological, and auditory disorders are possible with what therapy?
deferoxamine
deferoxamine infusions often have a negative impact on quality of life
a. true
b. false
a. true
compliance is an issue
__ is a low molecular weight, bidentate iron chelator
deferiprone
What is the half life of deferiprone?
3-4 hours
Is deferiprone dosed oral, IV, or subQ?
oral
three doses daily
What is the most serious AE of deferiprone?
agranulocytosis
__ is a trident ate iron chelator approved for once daily oral use
deferasirox
What is the plasma half life of deferasirox?
8-16 hours
Which iron chelator is administered as a suspension in fruit juice?
deferasirox
poorly water soluble
