Anemia and Hematopoietic Pharmacology Flashcards
Hypochromic-Microcytic Anemia
Treatment: Routes of Delivery (2) with Descriptions (2/4) and Adverse Effects (5)
Supplemental Iron
Oral: Ferrous Iron, taken without food
Parenteral: Iron Dextran, Iron Sucrose, Ferumoxytol
GI disturbance Anorexia Heartburn Dark stools Concern for anaphylactic shock (parenteral)
Iron Toxicity
Complications (3) Symptoms (5) Treatment
Necrotizing Gastroenteritis
Severe Metabolic Acidosis
Shock
Vomiting Abdominal Pain Bloody Diarrhea Lethargy Dyspnea
Parenteral Deferoxamine
Megaloblastic Anemia
Causes (6) Treatments (3)
Vitamin B12 Deficiency: Veganism Pernicious anemia (AI B12 loss) Gastrectomy Ileal resection
Folate Deficiency:
Jejunal resection
Alcoholism
Oral B12
Parenteral B12 (if neuro symptoms)
Oral Folate
Epoetin alfa
MOA, Uses (3) Delivery (2) Side Effects (2)
Glycoprotein that stimulates erythropoiesis
Anemia due to:
Chronic kidney disease
Cancer chemotherapy
Zidovudine HIV treatment
IV
Subcutaneous
Increases Diastolic BP (keep Hct 30-35)
Increased risk of CV events
Hydroxyurea
MOA (3) Indication, Delivery, Side Effects (4)
Inhibits ribonucleotide reductase causing S phase arrest
Decreases HbS
Boosts HbF
Sickle cell disease (only disease modifier available)
Oral
Painful difficult urination
Back pain
Fever/chills
Hoarseness
Eculizumab
MOA (3) Indications (2) Delivery, Side Effects (5)
Monoclonal Ab that binds complement protein C5
Blocks C5 cleavage preventing MAC formation
Inhibits intravascular hemolysis
Paroxysmal nocturnal hemoglobinuria
Atypical HUS
IV
Increased risk of infections HTN Headache Anemia Leukopenia
Sargramostim
MOA (3) Indications (3) Delivery (2) Side Effects (5)
Recombinant GM-CSF
Acts on bone marrow to stimulate common myeloid progenitor
Increases: Megakaryocytes, Erythrocytes, Neutrophils/Basophils/Eosinophils/Monocytes
Stimulate bone marrow after transplant
Pancytopenia
Collection of HSC’s via leukapharesis
Post-induction chemotherapy in AML
IV
Subcutaneous
Gasping syndrome (fatal in infants) Fluid retention Dyspnea Supraventricular Tachycardia Worsened Hepatic/Renal dysfunction
Filgastrin
MOA (2) Indications (3) Delivery (2) Side Effects (4)
human G-CSF
Increases neutrophil and basophil production
Neutropenia
Collection of HSC’s via leukapharesis
Decrease infections from myelosuppressive therapies
IV
Subcutaneous injection
Well tolerated
Mild bone pain
Splenic rupture
Acute respiratory distress syndrome
Plerixafor
MOA (2) Indications (3) Delivery, Side Effects (2)
CXCR4 receptor partial agonist
Mobilizes hematopoietic stem cells from marrow
Used as adjunct to G-CSF therapy if not responsive enough
Lymphoma
Multiple myeloma
Subcutaneous injection
Hypersensitivity reaction
Mobilization of leukemia cells
Oprelvekin
MOA (3) Indication, Delivery, Side Effects (4)
Recombinant IL-11
Promotes megakaryocyte growth/maturation
Increases platelet count
Thrombocytopenia (not used clinically much)
Subcutaneous injection
Edema
Cardiac dysrhythmias
Severe allergies
Bloodshot eyes
Romiplostim
MOA (3) Indications (2) Delivery, Side Effects (2)
Peptibody of IgG1 kapp heavy chains attached to peptide that activates TPO receptor
Increases platelet production
Idiopathic Thrombocytopenic Purpura*
Myelodysplastic syndrome
Subcutaneous injection
Well tolerated
Allergic reactions
*used if splenectomy doesn’t work
Eltrombopag
MOA (2) Indications (2), Delivery, Side Effect
Non-peptide TPO-receptor agonist
Increases platelet production
Idiopathic Thrombocytopenic Purpura*
Thrombocytopenia secondary to Hepatitis C cirrhosis
Oral
Hepatotoxicity if used with ribavirin/interferon
*used if splenectomy doesn’t work
Drugs That Cause Hemolytic Anemia (3)
Cephalosporins: Ceftriaxone and Cefotetan
Penicillins: Piperacillin
Drugs That Cause Thrombocytopenia (3)
Heparin
Quinidine
Quinine
Drugs That Cause Aplastic Anemia (5)
Chemotherapeutics: Alkylators, Antimetabolites, Antibiotics
Chloramphenicol
Benzene
