Antianemic Flashcards
Iron deficiency is a result of
restrictive diet (vegetarian), inadequate absorption(gastrectomy/malabsorption), increased need (pregnancy/ rapid growth), acute/chronic blood loss (menometorrhagia/upper digestive bleeding)
Iron salts classification
those administrated orally and those administrated parenterally
Iron salts administered orally
ferrous sulphate - first line, ferrous gluconate, ferrous fumarate, ferrous glutamate, ferrocholinate
Iron salts administered parenterally
iron dextran
iron salt contraindications
hemolytic anemia, hemosiderosis, hemochromatosis, pregnancy
Iron salt interactions
not with Cianocobalamin/Folic acid; absorption is increased by glucose, amino acids, ascorbic acid (30%), decreased by phosphates, bicarbonate, biliary acids,. antacids, Tetracycline
Vitamin B12 treatment
cyanocobalamin administered by IM or SC
Vitamin B12 mechanism of action
DNA synthesis/erythropoeisis, animal products (3-5 ug)
Vitamin B12 side effects
fever, chills, flushing, nausea, diarrhea
Folic acid
required for DNA synthesis and erythropoiesis, found in green vegetables, liver, fruit, 400 ug daily and 500-600 uh in pregnancy or lactation
Folic acid pharmacokinetics
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)
Folic acid indications
Macrocytic/megaloblastic anemia caused by folate deficiency (alcoholism, parenteral nutrition, tropical/nontropical sprue), prophylaxis of neural tube defects (spina bifida, anencephaly, encephaloceles)
Folic acid interactions - inhibit dihydrofolate reductase
Methotrexate, Trimethoprim
Drugs that interfere with absorption and storage of folate in tissues
anticonvulsants, oral contraceptives
Folic acid notes
hematologic improvement, neurological damage worsens and irreversible
Erythropoeitin pharmacokinetics
Half life is 4-8 hours after IV administration
Erythropoeitin mechanism of action
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
Erythropoeitin indications
CRF, after chemotherapy and prior to blood donation, anemia (surgery, AIDS, prematurity, chronic inflammation)
Erythropoeitin side effects
Dose dep. HBP (HT encephalopathy, seizures), thrombophlebitis, PE, influenza like symptoms, improves athlete performance (misuse)
Erythro contrraindications
Uncontrolled HBP
