Missed Flashcards
3 drugs to treat thrombocytopenia
- oprelvekin
- romiplastin
- eltrombopag
4 drug to treat neutropenia
- filgrastim (G-CSF)
- pegfilgrastim
- sargramostim (GM-CSF)
- plerixafor
3 drugs to treat anemia of chronic renal disease
- epoetin alfa
- hydroxyurea
- eculizumab
treatment for iron deficiency anemia
- RBC transfusion (if severe)
- oral ferrous (Fe+2) iron (200-400 mg/d in 2-3 doses)- take with water/juice only
oral ferrous supplements
ferrous sulfate, gluconate, fumerate
IV/IM iron supplements
iron dextrans
Na ferric gluconate complex
iron-sucrose complex
ferumoxytol
acute iron toxicity symptoms
- necrotizing gastroenteritis w/ vomit, AP, bloody diarrhea
- lead to shock, lethargy, dyspnea
- improvement can be follow by severe metabolic acidosis, coma, death
urgent treatment for acute iron toxicity
whole bowel irrigation and parenteral deferoxamine
sources of B12
- animal products (fish, meat, poultry, egg, milk)
- fortified breakfast cereals
how much B12 do you need a day?
what is your typical body store?
need 2 ug/d (usually get 5-7)
stores: 2-5 mg
what happens if B12 stores are depleted?
rapid neuro dysfunction (paresthesias, weakness, spasticity) that may not be fully reversible
- gait abnorm
- cognitive impairment
- irritability/weakness
Tx and dosage for B12 def
supplementation at 1-2 mg/d for 2 weeks, then 1 mg daily (~500X daily need)
-parenteral therapy if neuro sx are present (1000 ug/d for 1 week) then weekly for 1 month, then monthly
estimated daily req for folate
5-50 ug/d
- allowance: 400 ug/d (adults), 800 ug/d for pregnant/lactating
tx/dosage for folate deficiency
oral 1 mg/day x 4 months, if malabsorption then 1-5 mg/day
best folate sources
yeast, liver, kidney, green leafy veggies
Clinical use for Ach? MOA?
intraocular use to constrict pupils (miosis) during eye surgery
- direct cholinomimetic
Clinical use and MOA for bethanechol?
Urinary and GU - Ileus (increase motility)
urinary retention
heartburn
direct cholinomimetic, muscarinic selective
Clinical use for carbachol?
constrict pupil and decrease IOP in open-angle glaucoma
- direct cholinomimetic
- not selective
Clinical use for methacholine?
Asthma screening tool
- muscarinic selective, direct cholinomimetic
Clinical use for cevimeline
Tx dry mouth w/ Sjogren syndrome
- direct cholinomimetic
Clinical use of pilocarpine?
- Xerostomia (pt w/ sjogren, head and neck cancer)
- miosis (topical) in eye procedures
- Glaucoma (topical)
- Pure muscarinic agonist
- uncharged and highly absorbed
Main uses of direct cholinomimetics?
Eye Dz: glaucoma and accommodative esotropia
GI/GU Dz: post op ileus, congenital megacolon, urinary retention, esophageal reflux, xerostomia
Contraindications with direct cholinomimetics?
COPD/asthma
PUD
Clinical uses of indirect-acting cholinergic agonist?
- glaucoma (neostigmine
- Dementia (alzheimers and parkinsons): donepelil, galantamine, rivastigmine
- Antidote for anticholinergic poisoning (Physostigmine)
- reversal of NMJ paralysis (neostigmine)
- Myasthenia gravis (pyridostigmine, edrophorium, neostigmine)
What could cause a anticholinergic toxidrome?
atropine antihistamines TCA sleep aid cold preparations
Drugs to use for motion sickness? What class are they?
Anti-cholinergic
Scopolamine
Drugs for GI disorders?
- atropine: decrease motility
- dicyclomine (anti-spasmodic, IBS)
- glycopyrrolate: decrease secretions
- Hyoscyamine (IBS)
Anticholinergic Drugs for Ophthalmology (5)
- atropine
- cyclopentolate
- homatropine
- scopolamine
- tropolamine
Anticholinergic drugs for respiratory disorders (2)
- ipratropium
2. toitropium
Drugs for urinary disorders (urge incontinence) (5)
- darifenacin
- oxybutynin
- solifenacin
- tolterodine
- trospium
Drugs for cholinergic poisoning (DUMBELS)
Atropine + pralidoxime
Drugs for movement disorders
- Benztropine
- Biperiden
- Orphenadrine
- Procyclidine
- Trihexyphenidyl
What alkylating agent is a risk for renal tubular damage and ototoxicity?
cisplatin
What is a cholinomimetic and b-blocker that could be used to treat glaucoma?
pilocarpine (cholinomimetic)
timolol (beta blocker