Hematopoietic Flashcards
Statins
cholesterol lowering drugs (HMG-CoA reductase inhibitors)
side effects include rhabdomyolysis, increased risk of diabetes, and liver toxicity
Immune effects - suppress MHC-II expression, decrease leukocyte adhesion and extravasation, increase caspase 1, IL-1B, and IL-18, decrease IL-6
Drug Reaction with Eosinophilia and System Symptoms (DRESS)
anticonvulsant therapy
fever, rash, lymphadenopathy, eosinophilia, interstitial pneumonitis, myocarditis, hepatitis
Hemophagocytic Lymphohistiocytosis (HLH)
systemic inflammatory reaction associated with anticonvulsants
fever, rash, splenomegaly, cytopenias, elevated serum triglycerides and ferritin, decreased blood fibrinogen, decreased/absent NK cells, elevated CD25-positive white cells, hemophagocytosis
Mouse Local Lymph Node Assay (LLNA)
Drug applied to ear skin for 3 consecutive days
animals rested for 2 days then injected with 3H-thymidine
5 hours later, LNs removed and immune cell proliferation is measured (3x increase = positive response)
Guinea Pig Buehler Test
Drug applied to skin and covered with bandage for 6 hours on Days 0, 7, and 14
On Day 28, drug is applied same site on opposite side and covered for 24 hours
Erythema and edema are measured 24-48 hours after patch removal
Guinea Pig Maximization Test
Drug administered by intradermal injection on Day 0
Day 7 - drug administered topically at same location and covered for 48 hours
Day 21 - drug administered topically at same location and covered for 24 hours
Erythema and edema are measured 24-48 hours after patch removal
Scombroid fish poisoning
fish w/ high histamine levels (tuna, mackerel and others) as a result of mishandling
fish not properly refrigerated, bacteria convert histidine to histamine, which is heat-stable
anaphylactoid reaction often confused for type 1 hypersensitivity
Aplastic Anemia
Ionizing radiation and benzene
CCl4, Chloramphenicol, Penicillin, tetracycline, indomethacin, metals
Sideroblastic anemia
ethanol, isoniazid, pyrazinamide, cycloserine, chloramphenicol, zinc, lead, vitamin B6 or copper deficiency
Megaloblastic anemia
folate or vit b12 deficiency
hypersegmented neutrophils
phenytoin, primidone, carbamazepine, phenobartital, sulfasalazine, cholestyramine, triamterine
colchicine, neomycin, ethanol, omeprazole, hemodialysis
Hematological effects of lead
inhibits heme biosynthesis: d-aminolevulinic acid dehydratase (ALAD) and ferrochetalase
zinc replaces iron, resulting in accumulation of zinc-protoporphyrin
hypochromic anemia
Favism
consumption of fava beans in patients with glucose-6-phosphate dehydrogenase deficiency (decreased NADPH and glutathione levels)
RBCs already susceptible to oxidative injury and hemolysis. Fava beans contain high levels of oxidizing compounds
methlyene blue contraindicated in these patients because it is dependent on presence of NADPH. Vitamin C is alternative treatment.
eosinophilia–myalgia syndrome
associated with λ-tryptophan preparations contaminated with 1,1-ethylidene-bis[tryptophan]
Klaassen, Curtis D.. Casarett & Doull’s Toxicology: The Basic Science of Poisons, 9th Edition (p. 604). McGraw-Hill Education. Kindle Edition.
Coagulation factors
vitamin k dependent - II, VII, IX, X
Prothrombin Time (PT) measures the integrity of the extrinsic system as well as factors common to both systems
Partial Thromboplastin Time (PTT), which measures the integrity of the intrinsic system and the common components.
mechanisms by which erythrocytes counteract the formation of methemoglobin.
adenine dinucleotide (NADH)-methemoglobin reductase (also known as cytochrome b5 reductase), which converts 95% to 99% of methemoglobin to hemoglobin.
The second mechanism is via nicotine adenine dinucleotide phosphate (NADPH)-methemoglobin reductase, which requires a cofactor or electron receptor such flavin to reduce methemoglobin.
Klaassen, Curtis D.. Casarett & Doull’s Toxicology: The Basic Science of Poisons, 9th Edition (p. 599). McGraw-Hill Education. Kindle Edition.
