Pharm/Anemia Flashcards
Best form of oral iron
Ferrous
Deferoxamine MOA
Iron-chelator
Deferoxamine excretion & side effects
Urine - red
Acute iron overload - what do you give?
Deferoxamine
Deferoxamine side effects
Tachycardia, hypoT, shock
Deferoxamine route of admin
IV
Deferasirox indication
Chronic iron overload from multiple transfusions, and for acute iron overload due to ingestion
Deferasirox side effects
GI; auditory and visual disturbances; inc creatinine and hep enzymes
Two forms of B12 supplementation
Cyanocobalamin and hydroxocobalamin
Which form of B12 is best?
Hydroxocobalamin, because it is more highly protein-bound and remains longer
How does leucovorin interact with folic acid?
Reduces folate levels and rescues cells from folate antagonism (MTX); modulates effect of 5-FU
Levomofolate - what is it?
Bioactive form of folate in circulation
Methotrexate is liable to induce what kind of deficiency?
Folic acid via dihydrofolate reductase inhibition
How does phenytoin induce its folate deficiency?
Inhibits intestinal uptake
How does pyrimethamine induce its folate deficiency?
Similar to MTX, inhibits DHF reductase (not as badly though)
ESAs have these black box warnings
Chronic kidney disease and cancer (shortened survival/inc tumor progression) - use lowest dose sufficient to avoid transfusions
G-CSF MOA
Stimulates G-CSF receptors on neutrophil lineage, causing stimulation of growth and diff; permits use of PBSCs by mobilizing stem cells to blood
G-CSF and GM-CSF interact with these types of receptors
JAK/STAT
GM-CSF
Stimulates prolif/diff of granulocyte, erythroid, and megakaryocyte progenitors (broader action than G-CSF); stimulates T-cell proliferation
Synthetic G-CSFs
filgrastim, pegfilgrastim
Synthetic GM-CSF
sargramostim
Oprelvekin MOA
Stimulates megakaryogenesis/thrombopoiesis by binding to IL-11 receptor on megs; used to prevent thrombocytopenia
Oprelvekin side effects
Fatigue, headache, dizziness, CV effects
What is iron dextran?
IV form of iron
GM-CSF side effects
fever, malaise, arthralgia, myalgia, peripheral edema
GM-CSF and G-CSF - which has worse side effects?
GM-CSF