Exam 4 - Growth Factors Flashcards
1
Q
DRUG LIST
A
Iron, Folic Acid, Hydroxycobalamine,
Epoetin alpha, Darbepoetin, G-CSF, GM-CSF
2
Q
Hematopoiesis Required Nutrients (3)
A
- iron (better absorbed as ferrous ion; Vit C/HCl aid)
- folic acid
- B12
3
Q
Hematopoiesis
Growth Factors
A
- GCSF
- GM-CSF
- Epoetin
4
Q
Iron
Metabolism
A
- absorbed best as Ferrous ion
- Acidity/Vit C aid in absorption
- no excretion; only lost by bleeding or sloughing
- transferrin transports iron to tissues
- ferritin protein is storage form
- apoferritin responds to iron levels
5
Q
Iron
Acute Toxicity
A
- young children
- necrotizing gastroenteritis
- tx w/ chelation (deferoximine)
6
Q
Iron
Chronic Toxicity
A
- “hemochromatosis”
- iron deposition in tissues
- tx w/ chelation, phlebotomy
7
Q
Iron Therapy
Indications
A
- infants, children, pregnant/lactating women
- absorption (gastrectomy) d/o
- chronic bleeding
8
Q
Iron Therapy
ADME
A
- Iron salts 25% absorbed
- GI distress may preclude optimal dose
- multiple salts available
- titrate dose up gradually
9
Q
Iron Therapy
Tox/Side Effects
A
- epigastric distress
- abdominal cramps
- black stools
- take with meals (tho descreases absorption)
10
Q
Iron Therapy
Alternatives
A
- for GI intolerance
- IM or IV Iron dextran
11
Q
B12 Biochemistry
A
- B12 necessary for Methionine synth (SAM)
- B12 necessary for Purine Synth (via tetrahydrofolate)
- Deficiency inhibits DNA synth
- Deficiency has CNS effects
12
Q
B12 Deficiency
A
- Dietary deficiency takes years
- Usually caused by IF deficiency (absorption)
- Recall: IF from parietal cells
- Aborption of IF/B12 complex in ileum
- transported on transcobalmin II
13
Q
B12 Therapy
Administration Form
A
- inactive forms (Cyano- and Hydroxycobalamin)
- usually on tx for life for absorption pathology
- Folate tx can mask B12 deficiency (CNS sx not corrected)
14
Q
Folate Deficiency
Clin/Sx
A
- neural tube defects in pregnancy
- anemia
- 400mcg needed/day to maintain levels
15
Q
Folate
metabolism
A
-stored as polyglutamate
