Pharm of anemia

Question 1

what are the 7 classes of drugs used in the treatment of anemia

Answer 1

• iron
• Iron chelators
• vitamin B12 preparations
• Folic acid
• Erythrocyte-stimulating agents
• myeloid growth factors
• megakaryocyte growth factors

Question 2

What are the oral preparations of iron

Answer 2

• Ferrous sulfate
• Ferrous gluconate
• Ferrous fumarate

Question 3

What are the parenteral preparations of iron

Answer 3

• Iron dextran
• Iron-sucrose complex
• Sodium ferric gluconate complex

Question 4

What are the iron chelators

Answer 4

• Deferoxamine

- Deferasirox

Question 5

What are the vitamin B12 preparations

Answer 5

• cyanocobalamin

- Hydroxocobalamin

Question 6

What are the erythrocyte stimulating agents?

Answer 6

• Epoetin alpha (Epogen, Procrit)

- Darbepoetin

Question 7

what are the myeloid growth factors?

Answer 7

• Granulocyte colony stimulating factor: Filgrastim and Pegfilgrastim
• Granulocyte-macrophage colonly stimulating factor: sargramostim
• Plerixafor

Question 8

what are the megakaryocyte growth factors

Answer 8

• Oprelvekin, IL-11

- Romiplostim

Question 9

What form of iron is transported and stored?

What are the situations this can be absorbed?

Answer 9

• Ferric (3+)

- if it is in Heme like in meats

Question 10

What form of iron is normally absorbed?

Answer 10

-Ferrous (+2)

Question 11

Adverse effects of PO iron supplementation?

What advice do you give patient?

Answer 11

• Constipation, nausea, cramps, dark stools
• Take on empty stomach
• Separate iron supplementation and tetracycline/PPI

Question 12

If oral iron supplementation doesn’t work, what is next options?

Answer 12

Iron Dextran (both IV or IM)

Question 13

What is used for treatment of Iron overdose?

Answer 13

• Deferoxamine (IV, IM)

- Deferasirox (PO)

Question 14

Renal failure and lots of transfusions . . what growth factor is probably low

Answer 14

Erythropoietin

Question 15

What treatment will correct anemia in patient with low erythropoietin

Answer 15

Darbepoetin alpha or Epoetin alpha

Question 16

What is a myeloid growth factor given to treat neutropenia but NOT with AML or CML

Answer 16

Filgrastim

Question 17

What is a megakaryocyte growth factor (IL-11) used to treat Thrombocytopenia?

Answer 17

Oprelvekin

Question 18

What is erythropoietin supplementation (ESAs) almost always coupled with in patients with chronic kidney disease?

Answer 18

iron supplementation

Question 19

What drug related adverse effect comes with Darbepoitin alpha administration that respond with a dose dependent rise in Hct?

Answer 19

HTN and thrombotic complications

Question 20

What adverse effect comes with colony stimulating factors

Answer 20

Bone pain

Question 21

What is the most common cause of nonresponse to ESAs

Answer 21

rion deficiency

Question 22

after ESAs are given, when to reticulocytes peak?

When do Hct and Hgb rise?

Answer 22

• after 10 days

- 2-6 weeks

Question 23

what is the use of filgrastim when about to have adjuvant chemo?

Answer 23

reduce the risk and severity of chemo induced neutropenia

Question 24

bilirubin in pernicious anemia?

Answer 24

elevated

Question 25

Folate deficiency and pernicious anemia

Answer 25

causes it but WITHOUT neurological symptoms

Question 26

What are the vitamin B12 supplements?

Answer 26

Cyanocobalamin and Hydroxocobalamin

Question 27

Erythropoietin in anemia of chronic disease?

chemo induced?

Answer 27

• low

- high