Antianemic drugs

Question 1

Where is iron best absorbed?

Answer 1

• Duodenum and proximal jejunum

Question 2

How should iron be taken?

Answer 2

• Not with food, phosphates, tannates and phytate in food bind iron and prevent its absorption.
• 2 hrs before or 4 hrs after antacids
• Iron salt best absorbed in mildly acidic form, 250 mg Vit C or half glass of orange juice.

Question 3

What is iron dextran used for?

Answer 3

• Parenteral, IV or IM
• Must test with small amount for allergies
• Blood loss, IBS, kidney, cancer, heart disease

Question 4

What is ferric gluconate complex used for?

Answer 4

• IV infusion lower incidence of allergy

Question 5

When is iron sucrose used?

Answer 5

• IV only
• Limited to 300mg every 2-3 weeks
• Combined with EPO to prevent anemia in dialysis patients

Question 6

What is ferumoxytal and its use?

Answer 6

• Supermagnetic rion naoparticle

- Rapid IV for kidney disease

Question 7

What is ferric carboxymaltose?

Answer 7

• Stable complex for 15 min IV of 1000mg pre week

- Up to 1500 mg

Question 8

What are the side effects of iron IV?

Answer 8

• Fever, arthralgia, myalgia, constipation, diarrhea, thick green stool
• Self limiting
• Corticosteroids given theraputically
• Inflammation in arthritis patients
• 1-2g fatal in children
• Desferoximine for OD

Question 9

What are the erythrocyte factors?

Answer 9

• Iron
• B 12
• EPO

Question 10

What are the granulocyte factors?

Answer 10

• Filgrastim (G-CSF)

- Sargramostim (GM-CSF)

Question 11

What are the platelet factors?

Answer 11

• Oprelvekin (IL-11)
• Romiplostim
• Eltrombopag

Question 12

What are the two forms of cyanocobalamin in the body and their function?

Answer 12

• Methylcobalamin- HCN–> methionine

- Adenosylcobalamin- Methylmalonyl-Co–> succinyl-Co

Question 13

What are the 3 EPO therapies and there use?

Answer 13

• Erythropoietin
• Darbepoietin
• Methoxy poly ethyl glycol poietin
• Anemias, marrow suppressive therapies, to decrease need for transfusions.

Question 14

What is the primary function of filgrastim?

Answer 14

• Increases neutrophil production and activity

Question 15

What is the primary function of sargramostim?

Answer 15

• More general granulocyte stimulator

Question 16

What is the function of oprelvekin?

Answer 16

• Megakaryocytes–> platelets

- Neutrophils

Question 17

What is the function of Romiplostim and eltrombopag?

Answer 17

• Both bind to thrombopoietin receptor and stimulate platelet production.
• Romiplostim- human antibody fused to peptide
• Eltrombopag- synthetic peptide binds receptor