Anemia drugs Flashcards
Iron Preparation drugs
For microcytic anemia Ferrous sulfate Ferrous gluconate Ferrous Fumarate Iron dextran iron sucrose Sodium-ferric gluconate
Ferrous sulfate, ferrous gluconate, ferrous fumarate description
Oral iron therapy
Ferrous sulfate, ferrous gluconate, ferrous fumarate pharmacodynamics
works just as good as parenteral if absorption is normal
Ferrous sulfate, ferrous gluconate, ferrous fumarate indication
iron deficient anemia
Ferrous sulfate, ferrous gluconate, ferrous fumarate adverse
GI: Constipation, dark stools, cramps, vomiting, diarrhea
Iron dextran, iron sucrose, Sodium-ferric gluconate description
parenteral iron therapy
Iron dextran, iron sucrose, sodium-ferric gluconate pharmacodynamics
Toxicity is very rare; mostly occurs in young children after accidental ingestion
Iron dextran, iron sucrose, sodium-ferric gluconate indication
Patients who do not tolerate or absorb iron well
Extensive anemia that cannot be maintained on oral iron alone
Iron dextran, iron sucrose, sodium-ferric gluconate adverse
Acute iron toxicity -> necrotizing gastroenteritis with vomiting, abdominal pain, bloody diarrhea (-> possibly shock, metabolic acidosis, coma and death)
Treat-> deferoxamine
Iron chelator drugs
Deferoxamine
Deferasirox
Iron chelator description
Phlebotomy-for chronic iron overload without anemia
Iron chelator pharmacodynamics
Binds absorbed iron and promotes excretion
Iron chelator indication
Chronic iron toxicity:
Hemochromatosis or multiple transfusions
Vitamin B12 aka Cyanocobalamin
Hydroxycobalamin
Description
For macrocytic anemia
Parenteral (huge body stores take a long time to deplete)
Vitamin B12, cyanocobalamin, hydroxycobalamin pharmacodynamics
Two reactions:
homocysteine -> methionine
methyl-malonyl -> succinyl
Vitamin B12, cyanocobalamin, hydroxycobalamin indication
Malabsorption of Vit B12 (loss of IF,etc)
Can be partly correct with folic acid
Vitamin B12, cyanocobalamin, hydroxycobalamin adverse
Deficiency of cobalamin can cause neurologic abnormalities due to increased homocysteine
Folic acid description
macrocytic anemia
Deficiency is a lot more common than B12 but can be easily corrected
Folic acid pharmacodynamics
required for purine synthesis
Need B12 to for THF -> folate trap
Folic acid indication
Folate deficiency (1-6 months to develop) can cause congenital malformation and vascular disease Drug induced: MTX, trimethoprim, pyrimethamine (inhibit DHF reductase)
Folic acid adverse
Masking of neurologic deficits in B12 deficiency
Erythropoietin description
stimulates erythroid proliferation (JAK/STAT)
Erythropoietin pharmacodynamics
produced in the kidney in response to hypoxia
Erythropoietin indication
Anemia with renal disease (can’t produce endogenous EPO -> best responders)
