Anemia And Hematopoietic Growth Factor Drugs

Question 0

What two reactions does vitamin b12 play a role in?

Answer 0

Conversion of methylmalonyl coenzyme A (CoA) to succinyl CoA.
Synthesis of dTMP via folic acid metabolism.

Question 1

Where is vitamin b12 produced? How is it transported in the plasma? What two forms does it have? Which one has the longest circulating half life?

Answer 1

Produced only by bacteria. Plasma transport via transcobalamin II. Hydroxycobalamin and cyanocobalamin. Hydroxy cobalamin has the longer circulating half life.

Question 2

How does G-CSF (filgrastim) work? What is it indicated for? Administration? Side effects?

Answer 2

Stimulates G-CSF receptors expressed on mature neutrophils and their progenitors. Indicated for with congenital neutropenia, cyclic
neutropenia, myelodysplasia, and aplastic anemia • secondary prevention of neutropenia in patients undergoing cytotoxic chemotherapy • mobilization of peripheral blood cells in preparation for autologous and allogenic stem cell transplantation
Daily subq administration.
Bone pain and rarely splenic rupture

Question 3

What is the MOA of Oprelvekin? What is it indicated for? Administrated? Toxicities?

Answer 3

Activates IL11 receptors. Scondary prevention of thrombocytopenia in patients undergoing cytotoxic chemotherapy for non myeloid cancers. Daily sub q administration. Fatigue, headache, dizziness, anemia, fluid accumulation in the lungs and transient atrial arrhythmias.

Question 4

Which drugs inhibit ADP-induced expression of GpIIb/IIIa? What are they indicated for?

Answer 4

Clopidogrel, prasugrel, ticagrelor (reversible), ticlopidine

Acute coronary syndrome, coronary stenting

Question 5

Which drugs directly inhibit GpIIb/IIIa? What are they indicated for?

Answer 5

Abciximab, eptifibatide and tirofiban. Angioplasty with or without stent replacement