Antianemic

Question 1

Iron deficiency is a result of

Answer 1

restrictive diet (vegetarian), inadequate absorption(gastrectomy/malabsorption), increased need (pregnancy/ rapid growth), acute/chronic blood loss (menometorrhagia/upper digestive bleeding)

Question 2

Iron salts classification

Answer 2

those administrated orally and those administrated parenterally

Question 3

Iron salts administered orally

Answer 3

ferrous sulphate - first line, ferrous gluconate, ferrous fumarate, ferrous glutamate, ferrocholinate

Question 4

Iron salts administered parenterally

Answer 4

iron dextran

Question 5

iron salt contraindications

Answer 5

hemolytic anemia, hemosiderosis, hemochromatosis, pregnancy

Question 6

Iron salt interactions

Answer 6

not with Cianocobalamin/Folic acid; absorption is increased by glucose, amino acids, ascorbic acid (30%), decreased by phosphates, bicarbonate, biliary acids,. antacids, Tetracycline

Question 7

Vitamin B12 treatment

Answer 7

cyanocobalamin administered by IM or SC

Question 8

Vitamin B12 mechanism of action

Answer 8

DNA synthesis/erythropoeisis, animal products (3-5 ug)

Question 9

Vitamin B12 side effects

Answer 9

fever, chills, flushing, nausea, diarrhea

Question 10

Folic acid

Answer 10

required for DNA synthesis and erythropoiesis, found in green vegetables, liver, fruit, 400 ug daily and 500-600 uh in pregnancy or lactation

Question 11

Folic acid pharmacokinetics

Answer 11

polyglutamates are enzymatically hydrolyzed in GI tract to mono glutamates prior to SI absorption; converted in liver and plasma to metabolically active form (tetrahydrofolic acid) then distributed to the tissues, stored in liver (half, folate) and tissues (polyglutamate)

Question 12

Folic acid indications

Answer 12

Macrocytic/megaloblastic anemia caused by folate deficiency (alcoholism, parenteral nutrition, tropical/nontropical sprue), prophylaxis of neural tube defects (spina bifida, anencephaly, encephaloceles)

Question 13

Folic acid interactions - inhibit dihydrofolate reductase

Answer 13

Methotrexate, Trimethoprim

Question 14

Drugs that interfere with absorption and storage of folate in tissues

Answer 14

anticonvulsants, oral contraceptives

Question 15

Folic acid notes

Answer 15

hematologic improvement, neurological damage worsens and irreversible

Question 16

Erythropoeitin pharmacokinetics

Answer 16

Half life is 4-8 hours after IV administration

Question 17

Erythropoeitin mechanism of action

Answer 17

acts upon BM to stimulate cells to divide, changes of red cell lineage; increases erythropoietin synthesis rapidly by more than 100 fold in anemia and hypoxemia

Question 18

Erythropoeitin indications

Answer 18

CRF, after chemotherapy and prior to blood donation, anemia (surgery, AIDS, prematurity, chronic inflammation)

Question 19

Erythropoeitin side effects

Answer 19

Dose dep. HBP (HT encephalopathy, seizures), thrombophlebitis, PE, influenza like symptoms, improves athlete performance (misuse)

Question 20

Erythro contrraindications

Answer 20

Uncontrolled HBP