Drugs to Treat the Blood Disorders

Question 1

What are the two storage forms of iron?

Answer 1

Ferritin: water soluble Fe3+ (releases iron in controlled fashion)
Hemosiderin: particulate insoluble

Question 2

What is the major way that iron is lost in the body?

Answer 2

Bleeding

Question 3

What is the most efficient drug to replace iron intravenously?

Answer 3

Iron dextran (ferric iron)

Question 4

What form of iron is absorbed best in the intestines?

Answer 4

Ferrous (Fe2+)

Question 5

What form of iron is best used IV?

Answer 5

Ferric (Fe3+)

Question 6

Is IV or oral iron supplements safer?

Answer 6

Oral

Question 7

What affect on mitochondria can excess iron have?

Answer 7

Acidosis

Ferric iron can react with water and for Fe(OH)3 and hydrogen ion

Question 8

What is an important iron chelator?

Answer 8

Desferoxamine

Question 9

How does desferoxamine work?

Answer 9

Binds Ferric iron disallowing it to react with other compounds in the body

Question 10

What are the two treatments for chronic iron toxicity?

Answer 10

Primary: bloodletting
Secondary: desferoxamine

Question 11

What is epoetin alfa?

Answer 11

A erythropoietin analog made by recombinant DNA technology (glycosylated so longer half-life)

Question 12

What is darbepoetin?

Answer 12

A erythropoietin analog that is even more glycosylated and thus more stable

Question 13

What are two myeloid growth factors?

Answer 13

Filgrastim (G-CSF)

Sargramostim (GM-CSF)

Question 14

What is oprelvekin?

Answer 14

Recombinant form of IL-11 produced in E. coli; increases platelet formation in chemo patients

Question 15

What is romiplostim?

Answer 15

Small peptide linked to human Fc Ab segments; stimulates thrombopoeitin

Question 16

What affect does lower molecular weight of dextran have on the body?

Answer 16

Less anaphylaxis

Question 17

What do you treat pernicious anemia with?

Answer 17

Cobalamin or methylcobalamin and B12

Question 18

What does decreased folic acid or B12 cause?

Answer 18

THF cannot be produced and DNA synthesis is inhibited and blood formation is decreased

Question 19

What is needed for B12 to be absorbed?

Answer 19

Haptocorrin: Protects B12 from stomach acid

Intrinsic factor: Binds B12 to allow intestinal absorption

Question 20

What is Achlorhydria?

Answer 20

Intrinsic factor deficiency

Question 21

What is hemosiderosis?

Answer 21

Reversible, no tissue damage-cell deposition

Question 22

What is hemochromatosis?

Answer 22

Cellular and interstitial iron deposition

Question 23

What gene is mutated in hemochromatosis and hemosiderosis?

Answer 23

Hepcidin gene