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Phar 764 > Final Quiz: Anemia > Flashcards

Final Quiz: Anemia Flashcards

1
Q

Anemic Hgb Men

A

Under 13

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2
Q

Anemic Hgb Women

A

Under 12

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3
Q

Severely anemic Hgb Men/Women

A

7

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4
Q

Treatment for severe acute anemia

A

Give blood

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5
Q

Acute presentation of anemia

A

Heart-related problems

Fatigue-related problems

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6
Q

Macrocytic
Normocytic
Microcytic

A

> 100
80-100
<100

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7
Q

Low TSAT in acute anemia

A

Less than 20%

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8
Q

TIBC if iron-related

A

Over 400

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9
Q

TIBC if not iron-related

A

Less than 250

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10
Q

Normal Ferratin and change seen in iron-deficient anemia

A

100-200 : will be decreased

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11
Q

Normal Retics

A

1%

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12
Q

Normal MMA and change seen in B-12 deficiency

A

0.07-0.27 : will be elevated

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13
Q

Normal Homocysteine and change seen in B-12 AND Folate deficiency

A

Less than 15 : will be elevated

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14
Q

Site of iron absorption

A

Duodenum

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15
Q

Reasons for decreased Iron-absorption

A 
Duodenum removed
Enteritis
Chelation
- Di-valent cations
- Tetras/FQ/PCN
- Cholestyramine
Increased pH
- Achlorhydria
- Acid reducing agents
Levodopa/Methyldopa
Levothyroxine
Mycophenolate
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16
Q

Reasons for increased Iron-requirements

A 
Bleeding (including menstruation)
Rapid growth
- Infants
- Pregnancy
- Lactation
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17
Q

Progression of Iron-imbalance

A

Stores reduced : decreased Ferratin
Stores depleted : decraesed TSAT, increased TBIC
Anemic : Hgb less than normal

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18
Q

Signs of Iron-deficiency

A 
Glossitis (tongue)
Angular Cheilitis (mouth)
Koilnychia (nails)
Blue sclera
Pica
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19
Q

Oral Iron products and strengths

A

Ferrous Sulfate : 65mg elem. 20%
Ferrous Gluconate : 35mg elem. 11%
Ferrous Fumarate : 99mg elem. 33%

20
Q

SE’s from Oral Iron products

A 
Constipation
Nausea
Diarrhea
Abdominal cramping
Dark stools*
21
Q

Why are practitioners beginning to recommend q48hr dosing for Oral Iron products?

A

Hepcidin release in response to iron doses

- Decreases absorption for 48 hours

22
Q

Source of Iron

A

Anything with blood in it
Veggies
Nuts
Etc.

23
Q

Source of Folate

A

Green leafy veggies

24
Q

Source of B12

A

Animal products basically

25
Q

Main differences in symptoms between Folate and B12 deficiencies

A

Neurological symptoms with B12 deficiency only.

26
Q

What two drugs require Folate supplementation?

A

Methotrexate

Sulfasalazine

27
Q

Folate replacement therapy

A

1 mg PO daily ONLY if you have ruled out B12 deficiency

28
Q

What is IFa test used for?

A

To rule in or out Pernicious Anemia

29
Q

B12 replacement therapy if no neuro symptoms

A

1 mg PO daily

30
Q

B12 replacement therapy if + neuro symptoms

A

1 mg IM q48hr for 2 weeks
Then
1 mg IM monthly

31
Q

Most common cause of chronic anemia

A

CKD leading to decreased EPO production

32
Q

When is Iron-replacement therapy indicated in CKD patients?

A

When TSAT /< 30% regardless of +/- ESA

33
Q

Typical oral/IV iron dose in CDK patients

A

About 1,000mg elemental iron in both

34
Q

When to use caution with IV iron?

A

If patient has active infection.

35
Q

Iron Dextran

A

25mg test dose

100mg x 10

36
Q

When to hold iron therapy?

A

If TSAT > 50%

37
Q

INFeD

A

+/- 25mg test dose

1g over 8hrs

38
Q

IV Ferric Gluconate

A

125mg x 8

39
Q

IV Iron Sucrose

A

100-500 over 30min-4hr x 10

40
Q

When are blood tranfusions warranted?

A

If Hgb < 7
or
It’s really low and they are symptomatic

41
Q

When to consider ESA therapy

A

If Hgb < 10 AFTER or along with Iron replacement

42
Q

ESA therapeutic goal

A

Hgb 10-11

43
Q

Darbapoetin initial dose

A
  1. 45 mcg/kg monthly
    - IV if on dialysis
    - SQ if not on dialysis
44
Q

Epoetin alfa initial dose

A

50-100 units/kg/dose…

  • 3 times weekly IV if on dialysis
  • Weekly SQ if not on dialysis
45
Q

ESA-agent SE’s

A

Hypertension*

Thrombosis

46
Q

ESA agent conversion rules

A

If Epoetin 3xweekly -> Darba weekly
If Epoetin 1xweekly -> Darba bi-weekly
- Multiply Epoetin dose by 2 before converting

47
Q

ESA Resistance: Definition and Risk Factors

A

Definition: requiring more than 150 u/kg ESA 3xweekly.

Risk Factors:

  • Iron deficient
  • Aluminum tox. (decreases EPO prod.)

Phar 764 (15 decks)

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