CKD & ESRD

Question 1

Ferrous Sulfate

Answer 1

IND: Iron deficiency Anemia, first line
MOA: Oral Iron replacement
BOX: n/a
CON: Hemochromatosis, hemolytic anemia
ADR: Constipation, dark/tarry stool, other GI. MUST be taken on an EMPTY stomach. AVOID coffee, dairy, soy, spinach, and tea

Question 2

Iron Sucrose

Answer 2

IND: Fe Def Anemia in CKD
MOA: IV Fe
BOX: n/a
CON: n/a
ADR: Hypotension. Muscle cramps

Question 3

Ferumoxytol

Answer 3

IND: Fe def Anemia
MOA: IV Fe
BOX: Hypersensitivity/anaphylaxis. Infuse over 15 mins and observe for 30 mins. Billy saw a lady die.
CON: n/a
ADR: n/a

Question 4

Ferric Caboxymaltose

Answer 4

IND: Fe def Anemia
MOA: IV Fe. Did not exclude previous allergic pts to other iron supplements. NO reaction in pts that had a rxn with other agents. Billy Loves.
BOX: n/a
CON: n/a
ADR: Hypophosphatemia

Question 5

Ferric Gluconate

Answer 5

IND: Fe def anemia
MOA: IV Fe. No longer requires a test dose, still caution and use a test dose if pt has had a rxn to a previous agent
BOX: n/a
CON: n/a
ADR: CV, dizzy/HA, N/V/D, Erythrocyte abnormalities, injection site rxns, muscle cramps

Question 6

Iron Dextran

Answer 6

IND: Fe def (not Fe def anemia)
MOA: IV/IM Fe
BOX: Anaphylactic reactions, administer a test dose. Only use in pts with Fe def state. Higher risk.
CON: n/a
ADR: Anaphylaxis

Question 7

Epoetin Alfa

Answer 7

IND: Anemia d/t CKD, chemo, or Zidovudine. Don’t go over 11.5g/dL of Hgb because over 12 = increased mortality
MOA: Stimulates erythropoiesis
BOX: Increased risk of DVT, recommend prophylaxis. Cv. Cancer. CKD.
CON: Uncontrolled HTN, pure red blood cell aplasia
ADR: HTN. Pruritis. N/V. Arthralgia. Cough/fever

Question 8

Darbepoetin Alfa

Answer 8

IND: Anemia d/t CKD or Cancer. Don’t exceed 11.5Hgb
MOA: Stimulate erythropoiesis
BOX: CV events. CKD. Cancer
CON: Uncontrolled HTN. Pure red blood cell aplasia
ADR: Peripheral edema. Abdominal pain.

Question 9

Calcium Acetate

Answer 9

IND: Control of serum phosphorus
MOA: Phosphate binder in GI tract
BOX: n/a
CON: Hypercalcemia
ADR: Hypercalcemia and diarrhea

Question 10

Sevelamer

Answer 10

IND: Control serum phosphorus
MOA: Phosphate binder. Also lowers LDL and raises HDL
BOX: n/a
CON: Bowel obstruction
ADR: NVD, dyspepsia

Question 11

Ferric Citrate

Answer 11

IND: Hyperphosphatemia, Fe def Anemia
MOA: Phosphate binder. Leftover ferric iron goes into Hgb
BOX: n/a
CON: Fe overload syndromes
ADR: Diarrhea/constipation. Darkening of stool.

Question 12

Lanthanum

Answer 12

IND: Control serum phosphorus
MOA: Phosphate binder
BOX: n/a
CON: Bowel obstruction. fecal impaction. ileus
ADR: NVD

Question 13

Sucroferric Oxyhydroxide

Answer 13

IND: Hyperphosphatemia
MOA: Phosphate binder. NO Fe ABSORPTION
BOX: n/a
CON: n/a
ADR: Diarrhea, dark/tarry stool

Question 14

Vit D Analogues

Answer 14

Exist