anemia meds

Question 1

what kind of anemia is iron deficiency anemia?

Answer 1

microcytic hypochromic

Question 2

prefferred tx for iron deficiency anemia

Answer 2

ferrous sulfae 325 mg PO TID

Question 3

when to recheck hgb after tx for iron deficiency anemia

Answer 3

2-3 weeks

Question 4

ferrous sulfate admin

Answer 4

take with food
vitamin C increases absorption
do not take w other meds
can stain teeth
keep away from children - toxicity

Question 5

who is recommended prophylactic iron?

Answer 5

pregnant women
excessive menstrual blood loss
infants
adults with chronic blood loss

Question 6

iron AEs

Answer 6

iron can deposit in soft tissue - hemochromatosis

constipation, black stools, GI upset, anaphylaxis, HTN

Question 7

precautions for iron dosing

Answer 7

GI disease, ETOH, renal disease, liver impairment, hypersensitivity

Question 8

iron drug interactions

Answer 8

antacids, quinolones, tetracyclines

generally take 2 hrs apart from other meds

Question 9

hemochromatosis tx

Answer 9

iron chelators - deferoxamine, deferiprone

Question 10

Ganzoni’s formula

Answer 10

calculate iron replacement

weight in kg * (target hgb-actual hgb) * 2.4 + depot iron

Question 11

types of megaloblastic anemia

Answer 11

folate deficiency
vitamin B12 deficiency (pernicious anemia)

large MCV

Question 12

indications for folic acid therapy

Answer 12

anemia
pregnancy prophylaxis
vascular disease

some ETOH dependence, dialysis, liver disease, hemolytic anemia

Question 13

folic acid dosing for pregnancy

Answer 13

.4 mg daily

Question 14

folic acid dosing for anemia

Answer 14

1 mg daily

hgb will increase in 1-2 weeks

Question 15

contraindication to folic acid

Answer 15

B12 deficiency

Question 16

folic acid AE

Answer 16

nausea, bad taste

Question 17

other name for B12

Answer 17

cobalamin/cyanocobalamin

Question 18

cause of B12 deficiency

Answer 18

elderly loss of intrinsic factor – poor absorption

veganism

Question 19

B12 dosing

Answer 19

100-1000 mcg IM QD or Q2D

PO for prophylaxis

Question 20

B12 AEs

Answer 20

injection site pain, GI, HA, hypersensitivity, hypoK

Question 21

indications for erythropoietin stimulating agents

Answer 21

chemotherapy-induced anemia
chronic renal disease anemia
anticipated EBL >500 for surgery

target hgb 10-12
must be given with iron

Question 22

ESAs

Answer 22

epoetin

darbepoetin

Question 23

ESAs BBWs

Answer 23

renal disease -cardiovascular events w hgb >10
cancer - decreased survival - use lowest dose to keep hgb 10

avoid aggressive dosing!

Question 24

ESAs AEs

Answer 24

arthralgias, HA

HTN, CHF, thrombosis, seizures

Question 25

colony stimilulating factors

Answer 25

filgrastin

sargramostim

Question 26

filgrastim dosing

Answer 26

5mcg/kg SC or IV daily beginning day after chemo

preferred!!

Question 27

sargramostim dosing

Answer 27

250 mcg/m2 SC daily beginning day after chemo

more AEs than filgrastim

Question 28

colony-stimulating factors AE

Answer 28

bone pain, fever/chillls, rash, splenic rupture

Question 29

colony stimulating factor precautions

Answer 29

E coli, yeast allergy

resp distress, dyspnea, fluid retention

Question 30

oprelvekin MOA

Answer 30

simulates production of platelets and neutrophils

generally given to prevent thrombocytopenia

Question 31

oprelvekin AEs

Answer 31

CV side effects, fatigue, HA, dizziness

Question 32

thrombopoietin agonists

Answer 32

romiplostim
eltrombopag

similar limitations to oprelvekin