Pharm of anemia Flashcards
what are the 7 classes of drugs used in the treatment of anemia
- iron
- Iron chelators
- vitamin B12 preparations
- Folic acid
- Erythrocyte-stimulating agents
- myeloid growth factors
- megakaryocyte growth factors
What are the oral preparations of iron
- Ferrous sulfate
- Ferrous gluconate
- Ferrous fumarate
What are the parenteral preparations of iron
- Iron dextran
- Iron-sucrose complex
- Sodium ferric gluconate complex
What are the iron chelators
- Deferoxamine
- Deferasirox
What are the vitamin B12 preparations
- cyanocobalamin
- Hydroxocobalamin
What are the erythrocyte stimulating agents?
- Epoetin alpha (Epogen, Procrit)
- Darbepoetin
what are the myeloid growth factors?
- Granulocyte colony stimulating factor: Filgrastim and Pegfilgrastim
- Granulocyte-macrophage colonly stimulating factor: sargramostim
- Plerixafor
what are the megakaryocyte growth factors
- Oprelvekin, IL-11
- Romiplostim
What form of iron is transported and stored?
What are the situations this can be absorbed?
- Ferric (3+)
- if it is in Heme like in meats
What form of iron is normally absorbed?
-Ferrous (+2)
Adverse effects of PO iron supplementation?
What advice do you give patient?
- Constipation, nausea, cramps, dark stools
- Take on empty stomach
- Separate iron supplementation and tetracycline/PPI
If oral iron supplementation doesn’t work, what is next options?
Iron Dextran (both IV or IM)
What is used for treatment of Iron overdose?
- Deferoxamine (IV, IM)
- Deferasirox (PO)
Renal failure and lots of transfusions . . what growth factor is probably low
Erythropoietin
What treatment will correct anemia in patient with low erythropoietin
Darbepoetin alpha or Epoetin alpha
What is a myeloid growth factor given to treat neutropenia but NOT with AML or CML
Filgrastim
What is a megakaryocyte growth factor (IL-11) used to treat Thrombocytopenia?
Oprelvekin
What is erythropoietin supplementation (ESAs) almost always coupled with in patients with chronic kidney disease?
iron supplementation
What drug related adverse effect comes with Darbepoitin alpha administration that respond with a dose dependent rise in Hct?
HTN and thrombotic complications
What adverse effect comes with colony stimulating factors
Bone pain
What is the most common cause of nonresponse to ESAs
rion deficiency
after ESAs are given, when to reticulocytes peak?
When do Hct and Hgb rise?
- after 10 days
- 2-6 weeks
what is the use of filgrastim when about to have adjuvant chemo?
reduce the risk and severity of chemo induced neutropenia
bilirubin in pernicious anemia?
elevated
Folate deficiency and pernicious anemia
causes it but WITHOUT neurological symptoms
What are the vitamin B12 supplements?
Cyanocobalamin and Hydroxocobalamin
Erythropoietin in anemia of chronic disease?
chemo induced?
- low
- high
