Exam I Flashcards
What are the oral iron therapy drugs? How do you take them?
Oral Iron Therapy
Ferrous sulfate/gluconate/fumarate
Take w/ glass of water on empty stomach; can take w/ food to prevent GI AE
What are the AE of oral iron therapy drugs?
Oral Iron Therapy AE
Nausea and GI (cramps, constipation, diarrhea, black stools)
When do you use parenteral iron therapy instead of oral iron therapy? Why must you monitor iron levels carefully w/ parenteral iron?
Use parenteral for pt who cannot tolerate oral iron therapy or in pt where oral iron therapy isn’t adequate
Parenteral iron delivers more iron than can be stored which can lead to iron toxicity
What are the parenteral iron therapy drugs? How do you deliver?
Parenteral Iron Therapy Drugs
Iron dextran- deliver IV>IM
Iron sucrose and Na ferric gluconate- deliver IV
What are AE of parenteral iron therapy drugs?
Iron Dextran AE- HA, dizzy, fever, arthralgia, NV, flushing, urticaria, and bronchospasm (give small testing dose to check for hypersensitivies)
iron surcrose and Na ferric gluconate- hypersensitivity is rare
Who does acute iron toxicity affect and what does it result in? How do you treat it?
Acute iron toxicity primarily affects young children who accidently eat iron tablets leading to necrotizing gastroenteritis and shock
Treat w/ parenteral deforoxamine
Who does chronic iron toxicity affect and how do you treat it?
Chronic iron toxicity affects pt w/ hemochromatosis and pt who have had repeat transfusions
Treat w phlebotomy and deferasirox
B12 is rewquired for synthesis of what two products and deficiencies of B12 lead to inc amounts of why substrates as a result?
B12- methionine- deficiency leads to inc homocysteine
B12- succinyl CoA- defieicny leads to inc methylmalonic acid
Why is it best to give b12/cobalamin parenterally (think about the causes of deficiency)
B12 deficiency is typically due to malabsorption so you must give it parenterally
What are the EPO drugs (2)
Epoetin alpha (rhEPO)- give once a week or 3 times a week if chronic RF
Darbepoetin alpha- longer t1/2
What are the MOA of EPO drugs? What are the results and when should you expect them?
EPO induces erythropoiesis and release of reticulocytes into circ for maturation
Inc reticulocyte number w/in 10 days and inc Hb/Hc w/in 2-6 weeks
What are the uses of EPO drug therapy? With regards to one of the uses, what do you do along w/ EPO therapy?
Anemia secondary to kidney failure (couple w/ iron supplement)
Anemia due to BM disorders
Aplastic anemia, MDS, multiple myeloma, and AIDS)
What are AE of EPO therapy?
HTN and thrombosis
What are the myeloid GF drugs(4)? Info about how they are given, half-lives, and combos
Filgrastin- given IV or SC
Pegfilgrastin- longer t1/2 than filgrastin only requiring one treatment per myelosuppressive chemo cycle
Sargramostin- given IV or SC (SC has longer t1/2); GM-CSF
Plerixafor- use in combo w/ filgrastin to inc CD34 prior to transplant
Plerixafor
MOA
Who uses it
Plerixafor
MOA- inhibit SDF-1a from binding CXCR4 and mobilizes HSC to enter periph blood
Use in pt who don’t respond to G-CSF alone
