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PR3154 > IC3 > Flashcards

IC3 Flashcards

1
Q

Aplastic anaemia: what are the 2 syndromes?

A

1) Dose-dependent direct drug toxicity
2) Idiosyncratic - by means of toxic metabolites

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2
Q

Drugs that induce aplastic anaemia

A

1) Cancer chemotherapies, chloramphenicol
2) Carbamazepine, phenytoin

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3
Q

Drug treatment for aplastic anaemia

A
  • Immunosuppressants
  • GM-CSF (sargramostim)
  • G-CSF (filgrastim, pegfilgrastim)
  • IL-14
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4
Q

First step in management of drug-induced blood disorders

A

Withdraw causative drug where possible

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5
Q

Drugs that induce immune thrombocytopenia

A

Heparin, sulfonamides, carbamazepine, phenytoin, GP IIb/IIIa inhibitors

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6
Q

Drug treatment for immune thrombocytopenia

A

Immunosuppressants

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7
Q

Agranulocytosis: what are the 3 syndomes?

A

1) Direct drug toxicity
2) Toxic metabolite
3) Immune (hapten or complement) mediated

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8
Q

Agranulocytosis: causative drugs

A

Thiamazole, carbimazole, clozapine, beta lactams, propylthiouracil

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9
Q

Agranulocytosis: drug treatment

A

G-CSF or GM-CSF

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10
Q

Name for G-CSF

A

Granulocyte-colony stimulating factor

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11
Q

Name for GM-CSF

A

Granulocyte-macrophage colony-stimulating factor

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12
Q

Immune haemolytic anaemia: 3 syndromes

A

1) Drug-induced true autoantibody production
2) Innocent bystander (immune complex) autoantibody production
3) Hapten-induced haemolysis

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13
Q

Immune haemolytic: causative drugs

A

1) Methyldopa
2) Quinine, quinidine
3) Penicillins, cephalosporins, streptomycin

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14
Q

Non-immune haemolytic anaemia: syndrome

A

Protein adsorption

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15
Q

Non-immune haemolytic anaemia: causative drugs

A

Cisplatin, oxaliplatin, beta lactamase inhibitors

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16
Q

Haemolytic anaemia: drug treatment

A

1) Steroids and immunoglobulins have been used in serious cases
2) For autoimmune hemolytic anaemia, rituximab (human anti- CD20 monoclonal antibody) can be used

17
Q

Drugs used for neutropenia treatment

A

Myeloid growth factors e.g. G-CSF, GM-CSF

18
Q

Drugs used for thrombocytopenia treatment

A

Megakaryocyte growth factors / Platelet-Stimulating Agents (PSAs)

1) recombinant IL-11 (oprelvekin)
2) Fc-fusion protein thrombopoietin receptor agonist e.g.,
romiplostim
3) Oral nonpeptide thrombopoietin receptor agonists e.g., eltrombopag

19
Q

Features of RBC in iron-deficient anaemia

A

Few, small haemoglobin-poor RBC (paller)

20
Q

Features of RBC in VitB12/ folate-deficient anaemia

A

Very few, large Hb-rich RBC (redder)

21
Q

Acute adverse effects of iron supplements

A

Necrotizing gastroenteritis with vomiting, abdominal pain, and bloody diarrhoea followed by shock, lethargy, dyspnea, metabolic acidosis, coma and death

21
Q

Chronic adverse effects of iron supplements

A

Haemochromatosis with iron deposited in heart, liver, pancreas and other organs → organ failure, death

22
Q

Why is Hydroxocobalamin precursor preferred over cyanocobalamin?

A

Greater protein binding hence retained longer in circulation

23
Q

Why is vitamin B12 administered parenterally instead of orally?

A

Oral not usually effective as deficiencies are usually caused by GI malabsorption

24
Q

Adverse effects for hydroxocobalamin

A

1) Photosensitivity
2) Injection site pain
3) Hypotension, hot flushing

25
Q

DDI with hydroxocobalamin

A

PPI (reduce oral absorption)

26
Q

Adverse effects of folic acid supplements

A
  • GI disorders: Bitter or bad taste, nausea, abdominal distension, flatulence
  • Immune system disorders: Rarely, allergic reactions (e.g.rash,pruritus, erythema, urticaria, dyspnoea, shock); allergic sensitization.
  • Metabolism and nutrition disorders: Rarely,anorexia.
27
Q

Contraindication for ESA

A

Uncontrolled hypertension

28
Q

ADR for ESA

A
  • Hypertension, oedema; increased platelet count, thrombosis, stroke; hyperkalaemia; seizures; myalgia, arthralgia, limb pain; gastrointestinal effects including nausea and vomiting
  • Epoetin alfa: Pruritus
  • Darbepoetin alfa: Dyspnoea, cough, bronchitis
29
Q

ADR for G-CSF

A

bone pain, reversible when drug discontinued

30
Q

ADR for GM-CSF

A

fever, malaise, arthralgias, myalgias

31
Q

ADR for Megakaryocyte growth factors

A

Thromboembolic events

32
Q

ADR for IL-11 (Oprelvekin)

A

Fluid retention, peripheral oedema,
dyspnoea on exertion

PR3154 (19 decks)

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