ANEMIA drugs Flashcards
IRON → oral administration: (ex. of drugs)
- ferrous sulfate
- ferrous gluconate
- ferrous fumarate
IRON → parenteral administration: (ex. of drugs)
- iron dextran
- iron sucrose
- sodium ferric gluconate complex
IRON → pharmacokinetics:
- ORAL → 3x /day, various iron salts contain different % of elemental iron, 46mnd required in uncomplicated nutritional anemia
- PARENTERAL → IV / IM
IRON → indications:
prevention & treatment of microcytic hypochromic anemia caused by iron deficiency
IRON → CONTRAindications:
should NOT be given in hemolytic anemia (iron stores are elevated)
IRON → side effects:
- ORAL:
- epigastric pain
- nausea, vomiting
- diarrhea/constipation
- black stool (also in bismuth compound treatment or BLEEDING in the upper GI-tract)
- staining of teeth (oral prep.)
- PARENTERAL: (very dangerous, only in hospital setting)
- flushing
- hypotension
- inj. site reactions
IRON → ACUTE overdose:
- shock
- necrotizing gastroenteritis
- acidosis
- death
- treatment → remove tablets from gut, correct acid-base, & parenteral administration of deferoxamine = ANTIDOTE in toxicity of iron overdose (IV administration)
IRON → CHRONIC overdose:
- hemochromatosis → damaged organs which stores iron = heart, liver, pancreas
- treatment → parenteral deferoxamine (IV administration) or deferasirox (ORAL administration)
FOLIC ACID: (folate)
plays critical role in cell proliferation & erythropoiesis → required for normal DNA synthesis
FOLIC ACID → pharmacokinetics:
ORALLY
FOLIC ACID → indications:
- effective in prevention & treatment of megaloblastic anemia ass. with folic acid deficiency
- esp. important before & during PREGNANCY
- inadequate dietary intake → may cause neural tube birth defects
VITAMIN B12: (ex. of drugs)
- vit. B12
- cyanocobalamin
- hydroxycobalamin
VITAMIN B12 deficiency:
- inadequate secretion of intrinsic factor or malabsorption disorders, after gastrectomy, strict vegetarians/vegans
- causing neurologic defects → may become irreversible if NOT treated
- megaloblastic anemia = megakaryocyte anemia
VITAMIN B12 pharmacokinetics:
- dietary deficiency → ORALLY
- pernicious anemia → IM or deep SC
- not absorbed from the gut in absence of intrinsic factor
VITAMIN B12 indications:
- naturally occurring pernicious anemia
- anemia caused by gastric resection (gastrectomy)
- nutrition deficiency
ESAs → erythropoiesis-stimulating agents:
- epoetin alfa
- darbepoetin alfa
- epoetin beta
ESAs → pharmacokinetics:
- IV → in renal dialysis pat.
2. SC → in other cases
ESAs → indications:
- anemia caused by chronic renal failure
- anemia during chemotherapy of cancer
- bone marrow disorders
- prevention of anemia in premature infants
- anemia of AIDS
- anemia of chronic inflammatory diseases
ESAs → side effects:
- arthralgia, hypertension
- Hgb > 12mg/dL → serious CV events
- risk of stroke, MI, hypertension, HF, death
megakaryocyte growth factor: (drug name)
oprelvekin (recombinant IL-11)
megakaryocyte growth factor → mechanism of action:
- thrombopoietic growth factor
- directly stimulating proliferation of hematopietic stem cells & megakaryocyte progenitor cells
- induce megakaryocyte maturation → results in increased PLATELET production
megakaryocyte growth factor → indications:
- reduce thrombocytopenia in oncologic pat.
2. decrease need of platelet transfusions
factors used to acc. dev. of NEUTROPHILS: (drug names)
- filgastrim
2. sargramostin
factors used to acc. dev. of NEUTROPHILS → side effect:
bone pain
filgastrim → mechanism of action:
recombinant human granulocyte colony-stimulating factor = GCSF
filgastrim → indication:
acc. granulocyte recovery after myelosuppressive chemotherapy
sargramostin → mechanism of action:
recombinant human granulocyte macrophage colony-stimulating factor = GMCSF
sargramostin → indication:
acc. myeloid cell recovery in pat. with severe chronic neutropenia
(seen in lymphoma, leukemia, Hodgkin’s disease etc.)
