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M2 - Pharm > Anemia Drugs > Flashcards

Anemia Drugs Flashcards

1
Q

Dietary iron supplementation

A

Fe2+ (ferrous is two-plus): beef, chicken, pork, lamb, liver
Fe3+ (ferric): not absorbed as readily – leafy green veg, potato skins, tomatoes, dry beans, whole grains
Acidic things (ex: orange juice) help convert Fe3+ to 2+

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2
Q

Types of Oral Iron supplementation

A

Ferrous sulfate, ferrous fumarate, ferrous gluconate, carbonyl iron, Niferex

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3
Q

Oral Iron Toxicity

A

constipation, GI upset/cramping, black tarry stools, heartburn

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4
Q

Iron Absorption

A

duodenum + proximal jejunum, DMT1 transporter

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5
Q

Iron Storage in Liver

A

Ferritin

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6
Q

Iron Transport in Plasma

A

Transferrin

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7
Q

Iron Transport from Enterocyte to Blood

A

Ferroportin

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8
Q

Iron Storage in Bone Marrow

A

Reticulocyte uptake

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9
Q

Iron Absorption Promoters

A

Fe2+, Vit C, Acid, Fe deficiency, pregnancy, anoxia, increased erythropoiesis

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10
Q

Iron Absorption Reducers

A

Fe3+, Bases (pancreas) and acid reducers (PPIs), antibiotics (tetracyclines, fluoroquinolones), fiber supplements, diarrhea, decreased erythropoiesis, inflammation, dairy, grains/cereals, coffee, tea, soy,

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11
Q

Types of Parenteral Iron Supplementation

A

Iron dextran, Iron sucrose, Ferric gluconate

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12
Q

Effects of oral iron supplementation

A

7 days: reticulocytosis (modest); 3 weeks: 2 gm/dL rise in Hb

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13
Q

When is parenteral iron appropriate?

A

Intolerance of or noncompliance w/ oral therapy; Abnormal absorption 2/2 GI problem; Blood loss; Prep for EPO therapy

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14
Q

Parenteral Iron Toxicity

A

Injection site reactions, Diarrhea, Nausea, Anaphylactoid rxn

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15
Q

B12 deficiency causes

A 
Loss of IF (ex: pernicious anemia)
Ileum malabsorption
Dietary deficiency (rare b/c large stores)
PPIs
Metformin
EtOH
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16
Q

Types of B12 Supplementation

A

Oral (1-10mcg/d for dietary def, 1000mcg/d for absorption problem), Intranasal (Nasocobal), Parenteral

17
Q

Folate deficiency causes

A

Malnutrition, Alcoholism, Pregnancy, Malabsorption, Metformin, Anticonvulsants, Methotrexate

18
Q

Types of Folate Supplementation

A

Oral, Parenteral

19
Q

Erythropoeitin

A

synthesized by kidney; necessary for erythropoiesis; lost in chronic renal disease (normocytic anemia)

20
Q

Rx for Erythropoietin Deficiency

A

Epoetin alfa – recombinant, 2-3x/wk for dialysis pts

Darbepoetin alfa – longer half-life, give 1x/wk

21
Q

Risks of EPO drugs

A

CKD pts: Death and CV complications if Hb > 11 g/dL

Cancer pts: Tumor progression, Thromboembolic complications, death if Hb > 12 g/dL

22
Q

EPO abuse

A

EPO enhances endurance: “blood doping” – Banned by athletic organizations
Increases RBC concentration –> increased chance for spontaneous coagulation

23
Q

Colony Stimulating Factors (CSF)

A

Essential for differentiation and maturation of marrow cell lines; Treats neutropenia secondary to chemotherapy and bone marrow transplant

24
Q

Granulocyte CSF (G-CSF)

A

Stimulates neutrophils: Filgrastim, Pegfilgrastim

25
Q

Granulocyte-macrophage CSF (GM-CSF)

A

stimulates neutrophils and macrophages: Sargramostim

26
Q

Whole blood

A

Provides O2 carrying capacity, volume expansion

Uses: Acute hemorrhage, anemia, exchange transfusions in neonates, surgery

27
Q

Packed RBCs

A

Uses: Anemia (wide variety of types), Hypovolemia

28
Q

Fresh frozen plasma (FFP)

A

Uses: Coagulation factor deficiencies, ATIII deficiency, Immunodeficiencies (supplies Ig), Warfarin reversal, Massive blood transfusion (+Packed RBC), TTP

29
Q

Platelet transfusions

A

Uses: Thrombocytopenia (reduces bleeding risk), Prophylaxis in acute leukemia, Open heart Sx, DIC

30
Q

Cryoprecipitate Antihemophilic factor (AHF)

A

From FFP; Contains F8, 9, 13, fibrinogen, vWF

Uses: DIC, depleted fibrinogen (Not hemophilia)

31
Q

Iron Chelating Agent

A

Deferoxamine

32
Q

Iron Overdose

A

Vomiting, constipation, abdominal pain, bloody stools – Common in children b/c iron tablets usually taste sweet
Antacids w/calcium (like tums) help decrease absorption, but must treat w/chelator

M2 - Pharm (10 decks)

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