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NAPLEX > Iron Elemental Values > Flashcards

Iron Elemental Values Flashcards

1
Q

Ferrous Fumurate

A

33%

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2
Q

What are the goals of Iron Def Anemia Tx?

A

Increase in serum Hgb by 1g/dL every 2-3 wks

Continue Tx for 3-6 mo after anemia has resolved and iron stored return to normal

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3
Q

Carbonyl Iron

A

100%

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4
Q

Ferrous gluconate

A

12%

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5
Q

Ferrous sulfate 325 mg tablet

How much elemental iron?

A

65

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6
Q

Polysaccarharide iron complex

A

100%

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7
Q

Recommended dose for oral iron therapy

A

100-200 mg elemental per day

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8
Q

Oral iron absorption is decreased with? 3 things

A
  1. Food take iron on an empty stomach
  2. High gastric pH, avoid H2RA, PPIs separate from antacids
  3. Sustained release or enteric coated tablets cause less GI irritation
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9
Q

Ferrous sulfate dried

ER

160 mg tablet

A

50 mg elemental iron

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10
Q

Ferrous Sulfate

A

20%

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11
Q

Dx and Tx of Iron def anemia

Lab Findings

3 bullets 7 findings

A
  1. Decrease Hgb, Microcystosis <80, Decrease RBC
  2. Decreased serum iron, ferritin, and TSAT
  3. Availlable iron binding sites increase TIBC
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12
Q

Dried Ferrous sulfate

A

30%

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13
Q

Black box warning for Iron containing products?

A

Accidental overdose leading cause of poisoning in children call 911 or poison control immediately

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14
Q

Side effects of Iron products? 3

A
  1. Constipation
  2. Black tarry stools
  3. Nausea
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15
Q

What other vitamin can increase the absorption of Iron?

A

Vit C

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16
Q

What 4 specific drugs need to be separated from iron products?

A

Quinolones, tetracyclines, levothyroxine, Bisphosphanates

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17
Q

How should Iron be Taken?

What can it cause?

A

Taken on an empty stomach

Can cause black stools which is common, if constipated ask doctor for stool softeners.

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18
Q

Parenteral iron is reserved due to cost and side effects for what 5 populations?

A
  1. CKD pts on hemodiaylsis
  2. CKD receiving erythropoeisis stimulating agents
  3. Unable to tolerate oral iron celiac disease,
  4. Losing iron really quickly
  5. As an alternative when blood transfusions are not accepted by patients
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19
Q

Venofer

A

Iron sucrose

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20
Q

Ferumoxytol`

A

Feraheme

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21
Q

Black box warning for iron dextran and ferumoxytol

A

Serious anaphylactic rxn

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22
Q

How should iron dextran be given?

A

First give a test dose to see if they have an allergic response

23
Q

Triferic

What is the indication?

A

Indicated only for patients with hemodialyisis dependent CKD and should be added to the bicarbonate concentrate of the dialysate

24
Q

All IV irons have risk of?

A

Hypersensitivity Rxn

25
Q

Macrocytic anemia is caused by?

A

b12 or folate def

26
Q

Most common cause of B12 def?

A

Perncious anemia

27
Q

Long term use of what 3 drugs can cause B12 def?

A

Metformin, H2RA and PPIs

28
Q

B12 def anemia can cause of side effects?

A

Serious neurologic disfunction including peripheral neuropathy

29
Q

Macrocytic anemia is characterized by what lab findings?

A

Decreased Hgb increase MCV >100

30
Q

What is recommended as first line for patients with severe B12 def or neurologic symptoms?

A

B12 injections Cyanocobalamin

31
Q

Cyanocobalamin, B12 dosing?

A

IM or Deep SC

32
Q

What is Nascobal and what is the dosing?

A

Nasal Vit B12 500 mcg in 1 nostril once weekly

33
Q

What drug can decrease the efficacy of B12?

A

Chloramphenicol

34
Q

What drug can decrease the absorption of B12?

A

Colchine

35
Q

Folic acid can decrease the efficacy of what drug?

A

Raltetrexed Avoid combination

36
Q

Folic acid can decrease the serum concentration of what 4 drugs?

A

Fosphenytoin, phenytoin, primidone, phenobarbital

37
Q

What can decrease the serum concentrations of folic acid?

A

Green tea and sulfasalazine

38
Q

Anemia of CKD is primarily due to?

A

Def in Erythropoeitin

39
Q

What are the treatments for Anemia in CKD?

A

Iron and ESA

40
Q

What is first line for Hemodiaylisis pts?

A

IV iron

41
Q

What does ESA do?

A

Decreases the need for blood transfusions but are ineffective if iron stores are low

42
Q

Epogen, Procrit

A

Epoetin Alfa

43
Q

Dosing for Epogen or Procrit?

A

3x/wk

44
Q

When should epogen or procrit therapy be initiated and when should it be stopped?

A

When Hgb is <10

Decrease or interrupt dosing when Hgb approaches or exceeds 11

CKD patients on HD specifically

45
Q

Boxed warning for Epogen or Procrit? 6

A
  1. Increased risk of death
  2. MI
  3. Stroke
  4. VTE
  5. Thrombosis
  6. Tumor progression

Use lowest effective dose

46
Q

Epogen or Procrit risk in CKD pts

A

Increased risk of death and CV events when Hgb>11

47
Q

For cancer pts ESA is not recommended when?

A

Pts outcome is cure

48
Q

Aranesp

A

Darbepoetin

49
Q

What is the dosing for Aranesp?

A

Darbapeotin

Its once weekly

the half life is much longer than Epoetin alfa so it can be given weekly instead of 3x/wk

50
Q

How are ESAs stored?

A

Refridgerator

51
Q

What 5 things should you monitor when treating pts with ESA?

A
  1. Hgb
  2. Hct
  3. TSAT
  4. Serum Feritin
  5. BP
52
Q

11 drugs that cause hemolytic anemia?

A
  1. Beta lactamase inhibitors
  2. Cephalosporins
  3. Isoniazid
  4. Levodopa
  5. Methyldopa
  6. PCN especially piperacillin
  7. Platinum based chemo
  8. Quinidine
  9. QUinine
  10. Ribavirin
  11. Rifampin
53
Q

High risk drugs for hemolytic anemia when G6DP def? 8

A
  1. Chloroquine
  2. Dapsone
  3. Methylene blue
  4. Nitrofurantoin
  5. Primaquine
  6. Probenecid
  7. Rasburcase
  8. Sulfonamides
54
Q

What is the test to see if someone has hemolytic anemia?

A

Positive coombs test

NAPLEX (64 decks)

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