Anemia Pharmacology Flashcards
What are the PO drugs for Iron deficiency
Ferrous sulfate
Ferrous gluconate
Ferrous fumarate
What are the Parenteral drugs for Iron deficiency
Iron Dextran
Iron-Sucrose complex
Sodium ferric gluconate complex
How should the PO Iron deficiency drugs be taken
Water/juice on an empty stomach
When are the Parenteral Iron deficiency drugs given
When pts are unable to absorb PO iron or who have extensive chronic anemia
How is Iron dextran given
IV or IM
How is Iron sucrose complex given
IV
How is Sodium ferric gluconate complex given
IV
What are the SE’s of Iron dextran
HA, fever, arthralgias, N/V, back pain, flushing, urticaria, bronchospasm, anyphylaxis
What are the SE’s of the PO iron deficiency drugs
N, constipation or diarrhea, epigastric discomfort, ab cramps, black stools
What are the drugs for Iron toxicity and in what situation are they given
Deferoxamine –> Acute
Deferasirox –> Chronic
Sx’s = necrotizing gastroenteritis, V with ab pain, bloody diarrhea, lethargy, dyspnea
Acute iron toxicity
Pts with hemochromatosis are given which drug and where does it remove Iron from
Deferasirox
Liver
What are the drugs given for Vitamin B12 deficiency
Cyanocobalamin
Hydroxocobalamin
Sx’s = megaloblastic, macrocytic anemia with leukopenia and/or thrombocytopenia and paresthesias in peripheral nerves
Vitamin B12 deficiency
How are the Vitamin B12 drugs given
Parenteral
Sx’s = megaloblastic anemia with no neurologic sequelae
Folic acid deficiency
What drugs can cause folic acid deficiency
Methotrexate
Timethoprim
Pyrimethamine
Phenytoin
Which drugs stimulate erythrocyte production (mimic erythropoietin) and what is their difference
Epoetin-a (Epogen, Procrit) - 4-8 hr t1/2
Darbepoetin-a - 24-26 hr t1/2
What are the SE’s of erythrocyte-stimulating agents
HTN
Thrombotic complications
What are the most common 1˚ and 2˚ causes of anemia needing erythrocyte-stimulating agents
1˚ = BM disorders 2˚ = CKD
What drugs induce G-CSF and how are they different
Filgrastim - 2-3 hr t1/2
Pegfilgrastim - 15-80 hr t1/2
What drug induces GM-CSF and how can it be given
Sargramostim:
IV - short t1/2
SubQ - longer t1/2
What drug reversibly inhibits Stromal cell-Derived Factor-1a (SDF-1a)
Plerixafor
When is Plerixafor used
Prior to autologous transplantation or in pts who don’t respond well to G-CSF drug Tx
What is the SE of G-CSF drugs
Bone pain
What are the SE’s of GM-CSF drugs
Fever, malaise, arthralgias, myalgias, capillary leak syndrome
What drugs are megakaryocyte growth factors
Oprelvekin (IL-11)
Romiplostim
How does Oprelvekin (IL-11) work
Activates cytokine receptors on cells to stimulate growth of lymphoid and myeloid cells
How does Romiplostim work
Activates Mpl Thrombopoietin receptor to cause a dose-dependent increase in platelet count
What are the SE’s of Oprelvekin (IL-11)
HA, dizziness, fatigue, CV effects
What are the SE’s of Romiplostim
Mild HA on day of administration
Pts with Immune Thrombocytopenia Purpura (ITP) are given which drug if they are unresponsive to other Tx options
Romiplostim
