DRUGS USED TO TREAT ANEIMA

Question 1

Drugs to treat anemia

Answer 1

Iron
B12
Folic acid
HGF:erytoctye stimulatn agent

Question 2

Drugs to treat neutropenia

Answer 2

Myeloid growth factor : G-CSF : Filgrastim
GM:CSF:Sargramostim

Question 3

Drugs to treat/prevent thrombocytopenia

Answer 3

Megakaryocyte growth factors : IL-11Q

Question 4

Distingushing featrue of iron defeciency (type of anemia , Lap)

Answer 4

Microcytic hypochromic with MCV < 80fL and MCHC <30%

Lap : Low SI <30 mcg/dL
increased TIBC
Result in a tranferrin saturation of < 10 % ; low serum ferritin level <20 mcg/L

in conc : dec Hb dec MCV dec ferritin dec serum iron /TIBC
Hemoglobin >13,5 g/dl in males and >12.5 g/dl in female
MCV > 80fL
hematocrit : <41% in males and <36% in females

Question 5

Distingushing featrue of B12 (type of anemia , Lap)

Answer 5

Macrocytic nor-mochromic with MCV > 100fL norma MCHC

Lab : Low serum cobalamin < 100pmol/L
increase serum homocysteine > 13 mol/L
increase serum
increase urine methylmalonic acid >3.6 creatininie

Question 6

Distingushing featrue of folic acid (type of anemia , Lap)

Answer 6

low serum floic acid <4 ng/mL

Question 7

Low iron is due to what and clinical presentetion

Answer 7

low intake
blood loss
increase req during pregnency

pallor fatigue dizziness exetrioncal dyspnea tachycardia

Question 8

how do iron absorbed

1- where :

2-by which channel and what cell

3-What happen to heme iron when they enter

4-it is actively transported into the blood by

5- in the blood it is transported by and how enter the bone marrow
6- iron is stored as
7- how to estimate toal iron stores

Answer 8

1-duodenym and proximal jejunum

2-Ferrous is by DMT
Heme iron by HCP1
3-iron get released from heme

4-actively transported into the blood by ferroportin
5-by transferrin and by endocytosis
6-ferritin
7-serum ferritin level

Question 9

weird uses of iron suplment

Answer 9

for hookworm

Question 10

Drugs for oral iron therapy
dose
AE

Answer 10

Ferrous sulfate gluconate fumarate
dose : 200- 400 mg daily for 3-6 months

AE: nausea epigastric discomfort abdominal cramps and comstipation and diarrhea black stool

Question 11

Drugs for PARENTERAL iron therapy
used in? why we use it insted of oral
dose
AE

Answer 11

IRON DEXTRAN - SODIUM FERRIC GLUCONATE - IRON SUCROSE

1-with patient who unable to tolerate or absorb iron
e.g. (postgatrectomy - IBD )

DOSE : IM OR IV 50MG/ML

AE:headache ligh headedness fever arthlgias back pain . urtocaria (rash around the inj) bronchospasm .anaphylaxix

Question 12

Folate deficiency often due to ?

Answer 12

decrease oral intake and increast utilization or impared absorbtion

Question 13

Folate feciciency occur in which patheint

Answer 13

Alcoholic and elderly
IBD + Amyloidosis
pregnent cancer and sickle cell aneima beacuse there is an increase in utilization
drug that induce folate feficiency

Question 13

drug that induce folate feficiency ? 4

Answer 13

Methotrrexate
Trimethoprim———
:——–>inhibit dihydrofolate reducate
pyrimethamine ——
Long-term therapy with phenytoin

Question 14

folate deficiency symptoms

Answer 14

Glossitis
faitgue

Question 15

folate deficiency labs :

Answer 15

-smear shows macrocytosis with hypersegmented neutrophil
-decrease serum folate
increase serum homocysteine
normal methylmalonic acid levels

MCV >100fl macrocytic

Question 16

folate supplementation indications

Answer 16

prevention of : 1- NTD (spina bifida )
2-Prevention of vascular diseases ( Ischemic heart disease - stroke )

Question 17

B12 def symptoms :

Answer 17

Paresthesia (tinggling of hand ) + weakness in peripheral nervers progress to spasticity and ataxia

how can it casue that CNS-symptoms ? (methionine pathway distrubance )

Question 18

b12 labs : def

Answer 18

decerse cobalamin + increase hemoctstine + increase methylomalonic acid levels عكس folate

Question 18

drugs for b12 defecncy

Answer 18

cyano + hydroxo cobalamin

Question 19

Hematopoietic growth factor ?

Answer 19

1.Erythropoietin
2.Granulocyte colony stimulating factor G-CSF
3.interleukin-11

Question 20

What is the treatment of renal disease

Answer 20

exogenous erythropoietin

Question 21

Erythropoiesis stimulating agent is and what is the MOA

Answer 21

Epoetin alfa

MOA: agonist of erythropoietin receptor

Question 22

most aderves effect of Erythropoiesis stimulating agent are

Answer 22

HTN
Thrombotic complications

hemoglobin leave should be maintined under 12 g/dl

Question 22

indication for Erythropoiesis stimulating agent

Answer 22

chronic renal failure
hiv-infected patients treated with ZIDOVUDINE
cancer with how are treated with myelosuppressive cancer

Question 23

myeloid growth factor >

Answer 23

Filgrastim
sargramostim

Question 24

myeloid growth factor indication

Answer 24

cancer chemo induced neutropenia
congential neutropenia ,cyclic neutropenia
myelodysplasia (CANCER)
aplastc anemia

Question 25

Megakaryocyte growth factor ? name them

Answer 25

thrombopoietin and il-11 oprelvekin

Question 26

Megakaryocyte growth factor indication

Answer 26

thrombocytopenia

Question 26

Megakaryocyte growth factor indication

Answer 26

thrombocytopenia