Anemias Flashcards
Anemia Defined
Reduction of RBC’s or hemoglobin in the blood
Acute Posthemorrhagic Anemia / acute blood loss: Therapy
Hemostasis, restore blood volume, treat shock
Sickle Cell Anemia: Definition
Autosomal recessive d/o in which abnormal hgb leads to chronic hemolytic anemia
Presence of hemoglobin S in RBCs
When erythrocyte is stressed, the erythrocyte loses its oxygen causing the cell integrity to be lost and to sickle damaging the endothelium of the circulation
Sickle Cell Anemia Treatment Goals
Prevent and treat complications
Immunizations up to date
Folic acid supplementation 2/2 erythropoiesis
Hydroxyurea for Sickle Cell Anemia: MOA
Increases Hgb F levels, water content of RBCs, deformability of sickle cells, and alters the adhesion of RBCs to the endothelium
Iron Deficiency Anemia: Cause
r/t insufficiency iron intake, inadequate iron absorption, or increased iron demands
Iron is involved in the production of cytochromes and other enzymes.
Immediately bioavailable
Bound in the bloodstream to a specific carrier protein, transferrin
Iron Deficiency Anemia: Iron Replacement Therapy
Supplemental iron without food, adding vitamin C improves absorption
IV Iron Dextran
SE’s: nausea, vomiting, pruritus, HA, flushing, myalgia, arthralgia, back and chest pain
Iron Deficiency Anemia: Iron Replacement Therapy: SE’s
GI difficulties - discolored feces, anorexia, constipation, diarrhea, N/V
Iron Deficiency Anemia: Iron Replacement Therapy: Interactions
Many ABX cause decreased iron absorption
Decreased absorption when given with aluminum, calcium, or magnesium
PPI’s have decreased iron absorption
Anemia of chronic renal failure: Definition
Due to reduced EPO production by the kidney occurring when the GFR declines below 60mL/min
Anemia of chronic renal failure: Epoetin and Darbepoetin MOA
Recombinant hormones that stimulate the production of RBCs from the erythroid tissues of the bone marrow
Anemia of chronic renal failure: Epoetin and Darbepoetin Contraindications
In Pts with uncontrolled HTN
Hypersensitivity to human albumin
Anemia of chronic renal failure: Epoetin and Darbepoetin SE’s
HTN, HA, Sz, arthralgia, Nausea, edema, fatigue, diarrhea, vomiting, chest pain, asthenia, dizziness
Thalassemia Definition
Hereditary d/o of Hgb synthesis
India and China descent
Beta-Thalassemia: Mediterranean origin
Hemoglobinopathy is associated with decreased production of alpha or beta globins
Thalassemia Treatment
Folate
Avoid iron and oxidative drugs (sulfonamides)
Regular transfusion schedule for severe thalassemias
Iron chelation therapy
Vitamin B12 Deficiency: Pernicious Anemia Definition
Impaired deoxyribonucleic acid synthesis. Absence of intrinsic factor inhibiting absorption of vitamin B12
High risk; older adults, alcoholics, malnutrition, strict vegans, weight loss surgery
Vitamin B12 Deficiency: Pernicious Anemia Treatment
Vitamin B12 / Cyanocobalamin
Parenteral Cyanocobalamin every day x 1 week followed by once per week for 4 weeks
Folate Deficiency Anemia: Definition and cause
Lack of folate leads to large, functionally immature erythrocytes (megaloblasts)
Inadequate intake, inadequate absorption, inadequate utilization, increased requirement, increased excretions
Folate Deficiency Anemia: Symptoms
Weakness
Fatigue
Difficulty concentrating
Irritability
HA
SOB
Palpitations
Folate Deficiency Anemia: Treatment
Folate replacement
Diet rich in fruits and vegetables
Aplastic Anemia: Definition
Condition of bone marrow failure that can be hereditary or arise from injury to or abnormal expression of the stem cell
Pancytopenia with a hypocellular bone marrow
