ANEMIA drugs

Question 1

IRON → oral administration: (ex. of drugs)

Answer 1

1. ferrous sulfate
2. ferrous gluconate
3. ferrous fumarate

Question 2

IRON → parenteral administration: (ex. of drugs)

Answer 2

1. iron dextran
2. iron sucrose
3. sodium ferric gluconate complex

Question 3

IRON → pharmacokinetics:

Answer 3

1. ORAL → 3x /day, various iron salts contain different % of elemental iron, 46mnd required in uncomplicated nutritional anemia
2. PARENTERAL → IV / IM

Question 4

IRON → indications:

Answer 4

prevention & treatment of microcytic hypochromic anemia caused by iron deficiency

Question 5

IRON → CONTRAindications:

Answer 5

should NOT be given in hemolytic anemia (iron stores are elevated)

Question 6

IRON → side effects:

Answer 6

1. ORAL:
   
   1. epigastric pain
   2. nausea, vomiting
   3. diarrhea/constipation
   4. black stool (also in bismuth compound treatment or BLEEDING in the upper GI-tract)
   5. staining of teeth (oral prep.)
2. PARENTERAL: (very dangerous, only in hospital setting)
   
   1. flushing
   2. hypotension
   3. inj. site reactions

Question 7

IRON → ACUTE overdose:

Answer 7

1. shock
2. necrotizing gastroenteritis
3. acidosis
4. death
5. treatment → remove tablets from gut, correct acid-base, & parenteral administration of deferoxamine = ANTIDOTE in toxicity of iron overdose (IV administration)

Question 8

IRON → CHRONIC overdose:

Answer 8

1. hemochromatosis → damaged organs which stores iron = heart, liver, pancreas
2. treatment → parenteral deferoxamine (IV administration) or deferasirox (ORAL administration)

Question 9

FOLIC ACID: (folate)

Answer 9

plays critical role in cell proliferation & erythropoiesis → required for normal DNA synthesis

Question 10

FOLIC ACID → pharmacokinetics:

Answer 10

ORALLY

Question 11

FOLIC ACID → indications:

Answer 11

1. effective in prevention & treatment of megaloblastic anemia ass. with folic acid deficiency
2. esp. important before & during PREGNANCY
   • inadequate dietary intake → may cause neural tube birth defects

Question 12

VITAMIN B12: (ex. of drugs)

Answer 12

1. vit. B12
2. cyanocobalamin
3. hydroxycobalamin

Question 13

VITAMIN B12 deficiency:

Answer 13

1. inadequate secretion of intrinsic factor or malabsorption disorders, after gastrectomy, strict vegetarians/vegans
2. causing neurologic defects → may become irreversible if NOT treated
3. megaloblastic anemia = megakaryocyte anemia

Question 14

VITAMIN B12 pharmacokinetics:

Answer 14

1. dietary deficiency → ORALLY
2. pernicious anemia → IM or deep SC
   1. not absorbed from the gut in absence of intrinsic factor

Question 15

VITAMIN B12 indications:

Answer 15

1. naturally occurring pernicious anemia
2. anemia caused by gastric resection (gastrectomy)
3. nutrition deficiency

Question 16

ESAs → erythropoiesis-stimulating agents:

Answer 16

1. epoetin alfa
2. darbepoetin alfa
3. epoetin beta

Question 17

ESAs → pharmacokinetics:

Answer 17

1. IV → in renal dialysis pat.

2. SC → in other cases

Question 18

ESAs → indications:

Answer 18

1. anemia caused by chronic renal failure
2. anemia during chemotherapy of cancer
3. bone marrow disorders
4. prevention of anemia in premature infants
5. anemia of AIDS
6. anemia of chronic inflammatory diseases

Question 19

ESAs → side effects:

Answer 19

1. arthralgia, hypertension
2. Hgb > 12mg/dL → serious CV events
3. risk of stroke, MI, hypertension, HF, death

Question 20

megakaryocyte growth factor: (drug name)

Answer 20

oprelvekin (recombinant IL-11)

Question 21

megakaryocyte growth factor → mechanism of action:

Answer 21

1. thrombopoietic growth factor
2. directly stimulating proliferation of hematopietic stem cells & megakaryocyte progenitor cells
3. induce megakaryocyte maturation → results in increased PLATELET production

Question 22

megakaryocyte growth factor → indications:

Answer 22

1. reduce thrombocytopenia in oncologic pat.

2. decrease need of platelet transfusions

Question 23

factors used to acc. dev. of NEUTROPHILS: (drug names)

Answer 23

1. filgastrim

2. sargramostin

Question 24

factors used to acc. dev. of NEUTROPHILS → side effect:

Answer 24

bone pain

Question 25

filgastrim → mechanism of action:

Answer 25

recombinant human granulocyte colony-stimulating factor = GCSF

Question 26

filgastrim → indication:

Answer 26

acc. granulocyte recovery after myelosuppressive chemotherapy

Question 27

sargramostin → mechanism of action:

Answer 27

recombinant human granulocyte macrophage colony-stimulating factor = GMCSF

Question 28

sargramostin → indication:

Answer 28

acc. myeloid cell recovery in pat. with severe chronic neutropenia
(seen in lymphoma, leukemia, Hodgkin’s disease etc.)