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Year 2 Heme lymph > Exam I, Linger, anemia Tx, lec Part II > Flashcards

Exam I, Linger, anemia Tx, lec Part II Flashcards

1
Q

where is EPO in the body

A

peritubular interstitial cells of the kidney

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2
Q

how does inflammation or infection change EPO levels

A

suppress EPO secretion

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3
Q

how does EPO dosing need to be adjusted in patient with chronic renal failure

A

3x/week rather than once because dialysis

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4
Q

how is darbepoetin different than epoietin alpha

A

longer half life

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5
Q

MOA EPO

A

induces erythropoiesis by stimulating division and differentiation of committed erythroid progenitor cells
induces release of reticulocytes from bone marrow into blood stream

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6
Q

how does EPO change Hct and Hb? how long for drug effect?

A

increase Hct and Hb in 2-6 weeks

reticulocyte count inc in 10 days

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7
Q

why does chronic kidney disease cause anemia

A

kidneys cannot produce GF needed for erythropoiesis

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8
Q

what is EPO coulped with

A

iron supplementation

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9
Q

what are clinical uses EPO

A

chronic kidney disease
myelosuppressive chemo patients at last 2 mo regimen
anemia with HIV
reoperative elective surgery when Hb borderline low

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10
Q

ESA not indicated in what conditions

A

cancer patients receiving hormonal therapy, or chemi when expected to be curative
surgery patients who are willin to donate blood
surgery patients cardiac or vascular
RBC substitute requiring immediate correction anemia

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11
Q

off label use EPO

A

Tx symptomatic anemia in myelodysplastic syndrome

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12
Q

Sx toxicity of epo

A

HTN and thrombotic complications

icnresed mortality when used aggressivley in patients with chronic renal failure

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13
Q

what is EPO use contraindicated in

A

uncontrolled HTN

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14
Q

what is use of romiplostim

A

thrombocytopenia

idiopathic thrombocytopenic purpura

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15
Q

what is used of IL-11 or oprelvekin

A

thrombocytopenia in patients with nonmyeloid malignancies who receive myelosuppressive cancer chemo

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16
Q

what is difference of filgrastim and pegfilgrastim

A

peg has longer half life

17
Q

which myeloid growth factor was made in yeast

A

sargramostim

18
Q

what are the R of signaling with myeloid GF

A

members of cytokine R superfamily and initiate the JAK/STAT signal transduction pathway

19
Q

what do the G-CSF drugs do

A

stimulate proliferation and differentiation of progenitors already committed to neutrophil lineage

20
Q

how do the G-CSF drugs change peripheral blood

A

increase [ ] of hematopoietic stem cells in peripheral blood

21
Q

What is effect of GM-CSF

A

stimualte myelopoiesis
early and late granulocytic progenitor cells and erythroid and megakaryocyte progenitors
stimulates function of mature neutrophils
stimulates T cell proliferation together with IL-2

22
Q

which myeloid GF increases [ ] of peripheral blood stem cells the most

A

G-CSF

23
Q

What are uses of myeloid GF clinically

A

neturopenia from chemo
netruopenia from anything
patients undergoing high dose chemo because mobilizes the peripheral stem cells for collection by leukapheresis prior to chemo

24
Q

what are signs of G-CSF toxicity

A

bone pain

25
Q

signs of GM-CSF toxicity

A

fever, malaise, arthralgias, myalgias, capillary leak syndrome (peripheral edema and pleural or pericardial effusions)

26
Q

why is recombinatnt thrombopoietin not used clinically

A

production of autoAb that result in development of thrombocytopenia

27
Q

MOA oprelvekin IL-11

A

activates specific cell surface cytokine R to stimulate growth of multiple lymphoid and myeloid cells
acts synergistaclly with other growth factors to stimulate the growth of primitive megakaryocytic progenitors
increases # peripheral platelets and neutrophils

28
Q

what is romiplostim

A

peptide agonist of the thrombopoeitin R Mpl

29
Q

half life of this drug is inversely related to serum platelemt count

A

romiplostim

30
Q

MOA romiplostim

A

activates Mpl thrombopoietin R to cause dose dependent increase in platelet count that begins 5 days after subQ injection and peaks at 12-15 days

31
Q

what is IL-11 used for clinically

A

secondary prevention thrombocytopenia in patients receiving cytotoxic chemo for non-myeloid cancers

32
Q

what would you give to reduce number of platelet transufions in patient receieving cytotoxic chemo

A

IL-11 oprevlekin

33
Q

what is romiplostim used for

A

thrombocytopenia in patients with idiopathic thombocytopenic purpura who do not respond well to corticosteroids, Ig or splenectomy

34
Q

toxicity effects of IL-11

A

fatigue HA, dizziness and CV effects like transient arrhythmias
hypokalemia

35
Q

What are side effects romiplostim

A

mild HA on day of administration

Year 2 Heme lymph (28 decks)

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