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

A

epogen

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
Q

what stimulates EPO

A

hypoxia

26
Q

what is a 2nd gen ESA that has a longer halflife than epoetin alfa

A

darbepoetin

27
Q

what is the MOA of EPO

A
  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
Q

what does EPO tranform erythroid progenitor cells into

A

proerythroblasts

29
Q

what does EPO do

A
  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
Q

what are the 4 therapeutic uses of EPO

A
  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
Q

what is the onset of EPO when used for surgical pts to reduce the need for transfusion

A

2-6 weeks

32
Q

what are the 2 MC side effects of EPO

A

HTN and thrombotic complications

33
Q

what are other side effects of EPO

A
  • seizure
  • headache
  • stroke
  • chf
  • hemodialysis graft occlusoin
  • increased risk of death and serious CV
34
Q

Vitamin B12 is a (——-) containing moleculue

A

cobalt containing

35
Q

what coenzyme is essential for the production of methionine and S-adenosylmethionine to producte tetrahyrofolate

A

methylcobalamin

36
Q

what does deficiency leads to production of abnormal fatty acids

A

Vitamin B12

37
Q

what is the pharmacologic type of vitamin B12

A

Cyanocobalamin or hydroxocobalamin (alpharedisol)

38
Q

what does vitamin B12 complex with in the stomach

A

intrinsic factor (secreted by parietal cells)

39
Q

where is intrinsic factor vitamin B12 complex absorbed

A

active transport in the distal ileum

40
Q

where is vitamin b12 stored

A

in the hepatocytes

41
Q

what i

A