Anemia Drugs Flashcards
What are the 2 underlying causes of anemia?
Maturation defects: Cytoplasmic and nuclear
Destruction of RBCs:
Intrinsic and extrinsic
Name an erythropoiesis-stimulating agent
Epoetin alfa
What is epoetin alfa used for and when is it ineffective?
ID: Treatment of anemia associated with end-stage renal disease, chemo-induced anemia, and anemia associated with zidovudine therapy
Ineffective w/o adequate body iron stores and bone marrow function
What is the long-acting form of epoetin called?
Darbepoetin
What are the contraindications and most frequent adverse effects of epoetin alfa?
CI: Uncontrolled HTN, Hb levels >100 mmol/L for cancer pts and >130 mmol/L for pts with kidney disease, head and neck cancers; risk of thrombosis
AE: HTN, Fever, headache, pruritus, rash, nausea, vomiting, arthralgia, and injection site reaction.
Where is iron stored?
Liver, spleen, and bone marrow
What foods can enhance iron absorption?
OJ, veal, fish, ascorbic acid
What foods can impair iron absorption?
Eggs, beans, corn, cereal products containing phytates
Name 3 ferrous salts
Ferrous fumarate
Ferrous gluconate
Ferrous sulphate
Name 3 parenteral iron drugs
Iron dextran
Iron sucrose
Ferric gluconate
What are the indications of iron?
Prevention and treatment of iron deficiency syndromes
Alleviates symptoms of iron deficiency anemia
What are the adverse effects of iron?
Nausea, vomiting, diarrhea, constipation, stomach cramps and pain
Black, tarry stools
Liquid oral preps temporarily discolour teeth
What supportive measures help with iron toxicity?
Suction and maintenance of the airway
Correction of acidosis
Control of shock and dehydration with IV fluids or blood
Oxygen and vasopressors
What med is given to pts with severe symptoms of iron intoxication, such as coma, shock, or seizures?
Chelation therapy with deferoxamine mesylate
What is a consideration for the administration of iron dextran?
A test dose of 25 mg of iron dextran is administered before injection of the full dose, and then the remainder of the dose is given after 1 hour.
What is the indication for ferric gluconate?
Repletion of total body iron content in pts with iron deficiency anemia who are undergoing hemodialysis
Why is a test dose not required for ferric gluconate?
The risk of anaphylaxis is much less than iron dextran
What are doses higher than 125 mg of ferric gluconate associated with?
Increased adverse events, including abdominal pain, dyspnea, cramps and itching
What are the primary uses of folic acid?
Folic acid deficiency
During pregnancy, to prevent neural tube defects
What are the indications and forms for cyanocobalamin (Vitamin B12)?
ID: Pernicious anemia and other megaloblastic anemias
Forms: Orally or parentally
What are the contraindications of ferrous salts?
Ulcerative colitis, PUD, Liver disease, and other GI disorders
Iron dextran is contraindicated in all anemias except for ___________
Iron-deficiency anemia
Oral forms should be given with _______ but not ______________
Juice
Milk or antacids
What can be done to avoid esophageal corrosion?
Pts should remain upright for up to 30 minutes after taking oral iron doses
