Anemia & SCD

Question 1

VB12

Answer 1

Compounds that contain Cyanocobalamin
Nervous system damage when VB12 anemia
Treat anemia with Cyanocobalamin(VB12)
Oral is preferred if absorption is not impaired
IM/deep subQ or nasal spray are used if oral absorption is not adequate

Question 2

Cyanoacobalamin

Answer 2

VB12. For VB12 def anemia treatment and prevention
Dose varies depending on severity of anemia. 1000mcg daily for a week, then weekly, then monthly
Well tolerated

Question 3

Folic Acid

Answer 3

Have to make sure there’s no VB12 deficiency or we can exacerbate the neurologic effects of VB12
Anemias due to Folate deficiency
Well tolerated
Oral preferred
Avoid prophylactic use because it could mask VB12 Deficiency

Question 4

Hydroxyurea

Answer 4

Sickle Cell, CML, head and neck cancer
Increases Hgb F
BOX: Bone marrow suppression (severe myelosuppression), Secondary malignancy (carcinogenic, advise sun protection)
ADR: Eczema, Macrocytosis, Infections

Question 5

Voxelotor

Answer 5

SCD to prevent hemolysis and anemia
ADR: Rash, GI disturbances (NVD, abdominal pain), headache
Inhibits sickling
Extremely expensive

Question 6

Crizanlizumab

Answer 6

SCD
Reduces vaso-occlusive episodes and pain crises
Decreases PLT aggregation
ADR: Abdominal pain/nausea, back pain/arthralgia

Question 7

Prophylactic Penicillin

Answer 7

Until age 5 for SCD kids
3 months  - 3 years: Penicillin V 125mg 2x/day
3-5 years: Pencillin V 250mg 2x/day
Decreases infections and risk of death
Fever remains life-threatening

Question 8

Immunizations (SCD)

Answer 8

Normal schedule
Pneumococcal vax: PCV13 and PPSV23
Meningococcal vax
Yearly influenza vax