Anemia Pharmacology

Question 1

What are the PO drugs for Iron deficiency

Answer 1

Ferrous sulfate
Ferrous gluconate
Ferrous fumarate

Question 2

What are the Parenteral drugs for Iron deficiency

Answer 2

Iron Dextran
Iron-Sucrose complex
Sodium ferric gluconate complex

Question 3

How should the PO Iron deficiency drugs be taken

Answer 3

Water/juice on an empty stomach

Question 4

When are the Parenteral Iron deficiency drugs given

Answer 4

When pts are unable to absorb PO iron or who have extensive chronic anemia

Question 5

How is Iron dextran given

Answer 5

IV or IM

Question 6

How is Iron sucrose complex given

Answer 6

IV

Question 7

How is Sodium ferric gluconate complex given

Answer 7

IV

Question 8

What are the SE’s of Iron dextran

Answer 8

HA, fever, arthralgias, N/V, back pain, flushing, urticaria, bronchospasm, anyphylaxis

Question 9

What are the SE’s of the PO iron deficiency drugs

Answer 9

N, constipation or diarrhea, epigastric discomfort, ab cramps, black stools

Question 10

What are the drugs for Iron toxicity and in what situation are they given

Answer 10

Deferoxamine –> Acute

Deferasirox –> Chronic

Question 11

Sx’s = necrotizing gastroenteritis, V with ab pain, bloody diarrhea, lethargy, dyspnea

Answer 11

Acute iron toxicity

Question 12

Pts with hemochromatosis are given which drug and where does it remove Iron from

Answer 12

Deferasirox

Liver

Question 13

What are the drugs given for Vitamin B12 deficiency

Answer 13

Cyanocobalamin

Hydroxocobalamin

Question 14

Sx’s = megaloblastic, macrocytic anemia with leukopenia and/or thrombocytopenia and paresthesias in peripheral nerves

Answer 14

Vitamin B12 deficiency

Question 15

How are the Vitamin B12 drugs given

Answer 15

Parenteral

Question 16

Sx’s = megaloblastic anemia with no neurologic sequelae

Answer 16

Folic acid deficiency

Question 17

What drugs can cause folic acid deficiency

Answer 17

Methotrexate
Timethoprim
Pyrimethamine
Phenytoin

Question 18

Which drugs stimulate erythrocyte production (mimic erythropoietin) and what is their difference

Answer 18

Epoetin-a (Epogen, Procrit) - 4-8 hr t1/2

Darbepoetin-a - 24-26 hr t1/2

Question 19

What are the SE’s of erythrocyte-stimulating agents

Answer 19

HTN

Thrombotic complications

Question 20

What are the most common 1˚ and 2˚ causes of anemia needing erythrocyte-stimulating agents

Answer 20

1˚ = BM disorders
2˚ = CKD

Question 21

What drugs induce G-CSF and how are they different

Answer 21

Filgrastim - 2-3 hr t1/2

Pegfilgrastim - 15-80 hr t1/2

Question 22

What drug induces GM-CSF and how can it be given

Answer 22

Sargramostim:
IV - short t1/2
SubQ - longer t1/2

Question 23

What drug reversibly inhibits Stromal cell-Derived Factor-1a (SDF-1a)

Answer 23

Plerixafor

Question 24

When is Plerixafor used

Answer 24

Prior to autologous transplantation or in pts who don’t respond well to G-CSF drug Tx

Question 25

What is the SE of G-CSF drugs

Answer 25

Bone pain

Question 26

What are the SE’s of GM-CSF drugs

Answer 26

Fever, malaise, arthralgias, myalgias, capillary leak syndrome

Question 27

What drugs are megakaryocyte growth factors

Answer 27

Oprelvekin (IL-11)

Romiplostim

Question 28

How does Oprelvekin (IL-11) work

Answer 28

Activates cytokine receptors on cells to stimulate growth of lymphoid and myeloid cells

Question 29

How does Romiplostim work

Answer 29

Activates Mpl Thrombopoietin receptor to cause a dose-dependent increase in platelet count

Question 30

What are the SE’s of Oprelvekin (IL-11)

Answer 30

HA, dizziness, fatigue, CV effects

Question 31

What are the SE’s of Romiplostim

Answer 31

Mild HA on day of administration

Question 32

Pts with Immune Thrombocytopenia Purpura (ITP) are given which drug if they are unresponsive to other Tx options

Answer 32

Romiplostim