Antianemics

Question 1

What is the MOA of Ferrous Sulfate?

Answer 1

PO; iron supplement to replace iron lost in anemia; via emesis induction or lavage

Question 2

When would you use Ferrous Sulfate?

Answer 2

Microcytic anemia with low iron levels; required 3-6mo to get iron levels back to normal

Question 3

What are the side effects of Ferrous Sulfate?

Answer 3

Acute iron toxicity: NVD, GI pain, necrotizing gastroenteritis, shock, hypovolemia, heart/liver/renal failure due to free iron (reactive and free radical-producing); bad in kids

Question 4

What is the MOA of Iron Dextran?

Answer 4

IM; iron supplement replaces iron lost in anemia; via emesis induction or lavage

Question 5

When would you use Iron Dextran?

Answer 5

Microcytic anemia with low iron levels; used when PO doesnt work due to malabsorption

Question 6

What are the side effects of Iron Dextran?

Answer 6

Acute iron toxicity: NVD, GI pain, necrotizing gastroenteritis, shock, hypovolemia, heart/liver/renal failure due to free iron (reactive and free radical-producing); bad in kids

Question 7

What is the MOA of NaHCO3?

Answer 7

Converts free iron in GI to FeCO3

Question 8

When would you use NaHCO3?

Answer 8

Iron toxicity; acidosis, fluid loss, and shock associated with iron toxicity

Question 9

What is the MOA of Deferoxaine?

Answer 9

IV; chelates iron by forming H2O soluble feroxamine > excreted in urine

Question 10

When would you use Deferoxaine?

Answer 10

Iron Toxicity; acidosis, fluid loss, and shock associated with iron toxicity

Question 11

What are the side effects of Deferoxaine?

Answer 11

Allergic rxns, GI disturbances; Not used in pregnancy or renal dysfunction

Question 12

What is the MOA of Folic Acid?

Answer 12

Replaces lack of folic acid in body

Question 13

When would you use Folic Acid?

Answer 13

Macrocytic anemia with low folic acid; Give 600-800mcgs vs 400mcgs in pregnancy to counteract neural tube defects

Question 14

What are the side effects of Folic Acid?

Answer 14

Methotrexate, trimethroprim, oral contraceptives, alcohol, phenobarbital, and phenytoin interfere with folic acid action

Question 15

What is the MOA of Vitamin B12?

Answer 15

Replaces lack of B12 in the body; usually not PO

Question 16

When would you use Vitamin B12?

Answer 16

Macrocytic anemia with low B12; usually a malabsorption problem; need Intrinsic Factor for absorption

Question 17

What is the MOA of Erythropoietin?

Answer 17

Replaces lack of erythropoietin in body > stimulation of RBC production; given IV/SC

Question 18

When would you use Erythropoietin?

Answer 18

Anemia associated with chronic disease (CRF/ACD)

Question 19

What are the side effects of Erythropoietin?

Answer 19

Hypertension, thrombotic complications; must have enough iron for it to work

Question 20

What is the MOA of Filgrastim?

Answer 20

Enhances production of neutrophils > enhanced mobilization of hematopoietic SCs to blood > increase in WBCs

Question 21

When would you use Filgrastim?

Answer 21

Recovery from chemo/AIDS/Txp immunosuppression

Question 22

What are the side effects of Filgrastim?

Answer 22

Bone pain, splenomegaly, enzyme changes (LDH, AP, aminotransferases)

Question 23

What is the MOA of Sargramostim?

Answer 23

Stimulates growth of SCs into granulocytes and macrophages

Question 24

When would you use Sargramostim?

Answer 24

Accelerates myeloid recovery in chemo, bone marrow txp, AIDS to reduce potential for systemic infection

Question 25

What are the side effects of Sargramostim?

Answer 25

Fever, bone pain, myalgias, fluid retention; higher doses > pleural/pericardial effusions, capillary leak syndrome

Question 26

What is the MOA of Oprelvekin (IL-11)?

Answer 26

Stimulates growth of megakaryocytes > increased platelets

Question 27

When would you use Oprelvekin (IL-11)?

Answer 27

Treats thrombocytopenias in non-myeloid cancers

Question 28

What are the side effects of Oprelvekin (IL-11)?

Answer 28

Fatigue, headache, dizziness, dyspnea, atrial arrhythmias