Hematinics & Coagulants Flashcards
Which type of iron is absorbed readily in the duodenum?
Heme iron
How can ferric iron be absorbed?
Reduction to ferrous iron.
Transporter for ferrous iron?
DMT1
Iron enters circulation attached to
Transferrin
Iron is stored as
Ferritin
Elevated transferrin levels could indicate:
DECREASED Fe levels
Elevated ferritin levels could mean
INCREASED Fe levels
Peptide that reduces iron absorption in enterocytes and increases iron accumulation by macrophages
Hepcidin (hormone produced by liver)
Lifespan of RBC
120 days
1 mL RBC contains how much elemental iron
1 mg
Three foods that may impair iron absorption
tea, dairy, fish
What increases iron absorption?
Ascorbic acid
ADR of iron:
abdominal pain
nausea and vomiting
constipation
How many mg/day of elemental iron in iron replacement therapy?
300 mg/day
In oral iron replacement therapy, the goal for iron stores to reach how many g?
0.5-1g
Indications of parenteral iron therapy?
1) Patient cannot tolerate oral iron
2) Condition is acute
3) There is a continuous need for iron
Which parenteral iron preparation has the risk of anaphylaxis?
Iron dextran
Parenteral iron therapy is used to augment the response of
Recombinant EPO in patients undergoing dialysis
Excess iron depositions in chronic iron toxicity can be found in which organs?
Heart, liver, pancreas, other
IDA patients are prone to what toxicity?
Lead toxicity.
Lead absorption can be increased in patients with low dietary calcium, IDA, and ingestion on empty stomach.
Cobalamin (B12) or folate (B9) deficiency can cause what kind of anemia?
Megaloblastic (macrocytic type)
What kind of anemia can cause B12 deficiency?
Pernicious anemia (loss of gastric parietal cells –> decreased intrinsic factor –> impaired B12 absorption)
Why should folate not be used in B12 deficiency?
Folic acid may elleviate the anemia but allow the neurologic deficits from B12 deficiency to continue. Vit B12 deficiency impairs reutilization of folate, so effects of folate deficiency can manifest. Supplementing with folate can mask the B12 deficiency.
Indications of Epoetin alfa?
Also known as recombinant human erythropoietin. Anemia in chronic kidney disease. AIDS Cancer chemotherapy and surgery. Prematurity. Chronic inflammation
Modified form of EPO is also called
Darbepoetin alfa
Difference between G-CSF and GM-CSF potential?
GM-CSF has broader biologic actions. Multipotential hematopoeitic growth factor (granulocyte, megakaryocyte, erythroid).
Exogenous forms of GM-CSF/G-CSF?
Sargramostim
Filgrastim
Pegfilgrastim
Sargramostim is extracted from:
It is a form of :
yeast
recombinant human GM-CSF
Filgrastim is extracted from:
It is a form of:
E. coli
recombinant human G-CSF
Thrombocytopenia drug(s) with the following ADR: tachycardia palpitation edema shortness of breath
Oprelvekin
Thrombocytopenia drug(s) that is/are recombinant thrombopoietin
Romiplostim & Eltrombopag
Thrombocytopenia drug(s) that is/are recombinant IL-11
Oprelvekin
Vit K-dependent factors:
Factors II, VII, IX, X
Which Vit K form is synthesized by intestinal bacteria?
K2 (menaquinone)
This is why dietary requirement is low
Which Vit K form is a water soluble salt and should never be used therapeutically?
K3 (menadione)
Which Vit K form is found in food?
K1 (phytonadione)
Which Vit K form is found in human tissues?
K2 (menaquinone)
FDA-approved treatment for vWF bleeding:
Humate-P
Treatment for uncomplicated hemorrhage into a joint:
Factor VIII or Factor IX replacement
Initial loading dose for FVIII
50 units/kg daily in 2 divided doses
Fibrinolytic inhibitor similar to lysine
Aminocaproic acid (EACA)
Fibrinolytic inhibitor similar to EACA
Tranexamic acid
