Hematological Pharm Flashcards

1
Q

where is majority of the iron in the body found?

A

70% is found in hemoglobin

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2
Q

what is heme iron essential for?

A

muscle myoglobin, catalase, perosidase, cytochromes

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3
Q

where is iron stored in?

A
  • reticuloendothelial cells
  • Hepatocytes
  • intestinal cells as ferritin
  • hemosiderin
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4
Q

what is iron stored in the intestinal cells as

A

ferritin

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5
Q

where is iron absorbed most through?

A

intestine

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6
Q

what state of iron is more readily absorbed

A

Fe2+ is more absorbed than ferric state (Fe3+)

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7
Q

what acids promote the absorption of ferrous iron

A

gastric acid and asocrbic acid

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8
Q

when is iron oxidized to ferric iron

A

in the intestinal cell

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9
Q

what happens after iron is transferred into ferric iron

A
  1. stored as ferritin
  2. transported to other tissues
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10
Q

what is ferric iron transported in the plasma bound to

A

glycoprotein transferrin

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11
Q

iron storage is regulated at

A

the level of absorption

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12
Q

what happens to transferrin receptors when plasma iron concentrations are low

A

transferrin receptors increase which reduce tissue iron storage

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13
Q

when iron stores are high, what happens to intestinal absorption

A

decreased intestinal absorption

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14
Q

what happens to transferrin receptors when iron stores are high

A

tranferrin receptors decrease causing low cellular uptake

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15
Q

what is the order (lowest to highest) of iron by weight

for sulfate, gluconate, fumarate

A

gluconate < sulfate < fumarate

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16
Q

what percent of PO iron is actually absorbed

A

25%

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17
Q

how long can iron treatment take

A

3-6 months

18
Q

what is the typical PO dose of iron?

A

65-200mg iron/day

19
Q

Most common side effects of iroin

A
  1. GI upset (constipation, cramps, n/v)
  2. Bronchospasm/uticaria/anaphylaxis
20
Q

what drug treats iron toxicity

A

deferoxamine ( Desferal)

systematically or gastric lavage

iron chelating agent

21
Q

EPO stands fo

22
Q

what does EPO tx require

A

adequate stores of iron

23
Q

where is epogen produced

A

in the kidney’s peritubular cells

24
Q

what is epogen essential for?

A

reticulocyte production

25
what stimulates EPO
hypoxia
26
what is a 2nd gen ESA that has a longer halflife than epoetin alfa
darbepoetin
27
what is the MOA of EPO
1. increases the rate of proliferation & differentiation in erythroid precursor cells 2. in th ebone marrow 3. increase release of reticulocytes from marrow 4. increase hemoglobin synthesis
28
what does EPO tranform erythroid progenitor cells into
proerythroblasts
29
what does EPO do
1. increase proliferation & differentiation of erythroid precurosor cells 2. transformation of erythroid progenitor to proerythroblast 3. increase release of reticulocytes 4. increase hemoglobin synthesis
30
what are the 4 therapeutic uses of EPO
1. acquired immune deficiency syndrome treated with zidovudine AZT 2. Cancer pts undergoing chemotherapy 3. renal failure pts 4. surgical pts to reduce the ened for transfusions
31
what is the onset of EPO when used for surgical pts to reduce the need for transfusion
2-6 weeks
32
what are the 2 MC side effects of EPO
HTN and thrombotic complications
33
what are other side effects of EPO
* seizure * headache * stroke * chf * hemodialysis graft occlusoin * increased risk of death and serious CV
34
Vitamin B12 is a (-------) containing moleculue
cobalt containing
35
what coenzyme is essential for the production of methionine and S-adenosylmethionine to producte tetrahyrofolate
methylcobalamin
36
what does deficiency leads to production of abnormal fatty acids
Vitamin B12
37
what is the pharmacologic type of vitamin B12
Cyanocobalamin or hydroxocobalamin (alpharedisol)
38
what does vitamin B12 complex with in the stomach
intrinsic factor (secreted by parietal cells)
39
where is intrinsic factor vitamin B12 complex absorbed
active transport in the distal ileum
40
where is vitamin b12 stored
in the hepatocytes
41
what i