anemias and hematinic agents Flashcards
most common blood disorder is what
anemia
anemia results from what
defect in RBC formation or function- tissue does get enough O2
what is needed from the liver to make RBC
erythropoietin
do erythrocytes have nucleus?
no, they lose it during formation
what is nutritional anemia called
microcytic anemia (iron deficiency anemia) (tired blood)
cause of microcytic anemia
relative lack of iron- RBC are small, pale looking
does the body have mechanisms to eliminate iron?
no
iron is broken down in stomach by what
HCL
iron is absorbed as what form
Fe2+ ferrous iron
iron is transported as what form
Fe3+ feric iron
what converts Fe2+ to Fe3+
transferrin
what carrier iron throughout body
transferrin
T/F transferrin increases during times of anemia
True
excess iron is stored as what and where?
ferritin in liver
excess loss of iron leads to what?
chronic blood loss
ecology of iron deficiencies
- not enough in diet
- decreased absorption if HCL is very low or other GI dysfunctions
- increased requirements- pregnancy, body growth.
drug of choice of microcytic anemia
iron, speciccaly FeSO4-, orally, cheap, effective
SE of iron intake
GI upset
nausea
can you take iron via parenterally?
yes, severe deficiency
can taking iron orally be toxic?
yes, in small children, lethal dose could be little as 3. grams/ 10 tablets
acute iron toxicity
nausea abdominal pain drowsiness cardio collapse convulsions or death
treatment of acute iron toxicity
iron chealators, deferoxamine
chronic toxicity of iron and treatment
hemochromatosis (too much stored), treatment is phlebotomy- bleeding somebody
macrocytic anemias
large RBC precursors. due to inhibition of DNA synthesis
___ ____ is needed for DNA replication
folic acid
symptoms of folic acid deficiency
macrocytic RBC precursors
etiology of folic acid deficiencies
intake deficiency
drugs can inhibit synthesis of active form
folic acid deficiency in pregnancy can caused what
neural tube defects
folic acid deficiency leads to deficiencies to what other molecules
methionine and dTMP (don’t make enough thimadine which is needed for RBC synthesis)
therapy of folic acid deficiency
oral therapy is usually sufficient
therapy if there is an absorption abnormality.
parenteal therapy. no toxicities, no contraindications
function of B12
essential for DNA synthesis and methionine
symptoms of B12 deficiency
- megaloblastic anemic,
- lack of methionine causes decrease in myelin synthesis –> neuronal damage, weakness, ataxia, opacity, irreversible spinal cord damage
etiologies of B12 deficiency
mainly decrease in absorption, most common
what does parietal cells make that B12 requires to get absorbed
Gastric inrinsic factor (G.I.F)
pernicious anemia
pt. lacks ability to make G.I.F, can’t absorb B12 which is needed for RBC synthesis, so low RBC’s
in pernicious anemia how is B12 given?
by injection
if B12 deficiency isn’t due to pact of GIF how to you correct deficiencies?
orally
anemias due to chronic renal failure or chemo. list or drugs
epoietin alfa
darbepoietin
peginesatide
why does anemia happen in chronic renal failure or chemo?
liver isn’t making erythropoietin like it should be.
hemolytic anemia is what
abnormal lysis of RBC. iron not generally helpful, erythropoietin useful though
toxicities of drugs used with chronic renal failure are due to what
due to excess of RBC, increase BP, increase clotting, stroke
sickle cell anemia
abnormal flow of RBC- change shape, hard to get thoruhg caps
drug used for sickle cell anemia
hydroxyurea
hydroxyurea
increase formation of fetal hemoglobin which does not sickle.
SE of hydroxyurea
mutagenic
preg category D
