Anemia Pharm Flashcards
What are dietary sources of iron?
- meat
- fish
- poultry
What are oral iron supplements?
ferrous irons (ferrous sulfate, ferrous cluconate, ferrous fumarate)
What adverse effects are associated with oral iron supplements?
What can be done to lessen these symptoms?
N/V/D, constipation, dark stools, heart burn
Take with food, decreases absorption -> decreases irritation
What is the common presentation of actue iron toxicity?
(who and what symptoms)
only young children
-necrotizing gastroenteritis -> vomiting, abdominal pain, bloody diarrhea
develops into shock, lethargy, and dyspnea (from blood loss)
What is the common presentation of chronic iron toxicity?
(who and what symptoms)
hereditary hemochromatosis and chronic blood transfusions
iron deposits in heart, liver, and pancreas -> organ failure
What drug is used to treat iron poisoning?
deferoxamine
(de-iron)
What are dietary sources of vitamin B12?
Animal products (meat/poultry/fish, eggs, dairy products)
What routes of admission of vitamin B12 are used in vitamin B12 deficiencies?
high dose oral administration normally (500x daily need)
parenteral with neurologic symptoms
What are dietary sources of folate?
leafy green vegetables, yeast, liver, kidney
What is epotin alfa?
What conditions is it used for?
recombinant EPO -> stimulates erythropoiesis
- anemia of chronic disease
- anemia due to chemotherapy
What are adverse effects of epoetin alfa?
related to thicker blood
- stroke
- MI
- embolism
What is hydroxyurea?
What is is used for?
ribonulceotide reductase inhibitor
- sickle cell anemia (increases HbF prodcution -> decrease %HbS, only drug used to treat)
- used as chemotherapeutic (S phase arrest)
What is eculizumab?
What is is used for?
monoclonal Ab against complement C5
decreases abberant complement activation
- paroxysmal hemoglobinuria
- hemolytic uremic syndrome (HUS)
What is filgrastim?
What is it used for?
G-CSF -> increased granulocytes (neutrophils and basophils)
-myelosuppresive chemotherapies (non-myeloid malignancies only!!!)
-prior to bone marrow collection for transplant
-severe chronic neutropenia
What is pegfilgrastim?
What is it used for?
G-CSF -> increased granulocytes (neutrophils and basophils)
longer lasting version of filgastim
What is sargramostim?
What is it used for?
GM-CSF -> increased myleoid lineage (WBCs, RBCs, and platelets)
STIMulates proliferation
- prior to bone marrow transplant for collection and after for proliferation
- following treatment for AML
Which of filgastrim and sargramostim should be used for febrile neutropenia?
filgrastim
- cheaper
- less side effects
What is plerixafor?
What is it used for?
CXCR4 agonist
- CXCR4 homes stem cells to bone marrow, this blocks that receptor, stopping them to stay in circulation
- when not enough stem cells are mobilized from G-CSF (filgrastim) to collect, this increase the amount mobilized
What is romiplostim?
What is it used for?
activates TPO (thrombopoietin) receptor -> increased platelets
-second line for IPT
What is eltrombopag?
What is it used for?
TPO receptor agonist
-second line for IPT
What are the main drugs that cause hemolytic anemia?
- cephalosporins (cextriaxone and cefotetan)
- penicillins (piperacillin)
What are the main drugs that cause thrombocytopenia?
- heparin (-> HIP)
- quinidine/quinine (anti-malarials)
What are the main drugs that cause aplastic anemia?
- chemotherapeutics
- chloramphenicol
- benzene
