Pharmacology and Pharmacotherapy of Neutro/Thrmbocytopenia

Question 1

What is neutropenia?

Answer 1

Granulocye disorder with low number of neutrophils

Question 2

Mild neutropenia is?

Answer 2

1000-1500

Minimal risk of infection

Question 3

Moderate neutropenia is?

Answer 3

500-1000

Moderate risk of infection

Question 4

Severe neutropenia is?

Answer 4

<500

Severe risk of infection

Question 5

What is thrombocytopenia?

Answer 5

Decrease in platelets within the blood

<100,000

Question 6

Decreased platelet count due to?

Answer 6

Decreased production
Increased destruction
Drug-induced

Question 7

What are hematopoietic growth factors?

Answer 7

Glycoproteins that are secreted from bone marrow cells and peripheral tissue
ACTIVE AT LOW CONCENTRATIONS
Interact synergistically with other factors

Question 8

Proteins produced in prokaryotes show?

Answer 8

No glycosylation

Question 9

Proteins produced in eukaryotic cells are?

Answer 9

glycosylated

Question 10

Degree of glycosylation can affect?

Answer 10

PK
Biological activity
Antigenicity
Toxicity

Question 11

What stimulates stem cells to form a series of burst-forming units (BFU) and colony forming units (CFU)?

Answer 11

Stem cell factor
FLT-3 ligand
IL3
GM-CSF

Question 12

What is SCF

Answer 12

Cytokine/Hematopoietic Growth Factor involved in regulation in the early stages of hematopoiesis
- Promote HSC survival and self-renewal

Question 13

SCF exerts its effects by binding to what receptor?

Answer 13

CD117

Question 14

SCF bind with its receptors creates?

Answer 14

Docking sites for signal transduction molecules

Question 15

ANCE STIM

Answer 15

Soluble SCF

Question 16

What is Granulocyte- Colony Stimulating Factor (G-CSF)?

Answer 16

GF that stimulates proliferation and differentiation of colony forming unit committed to the neutrophil lineage

Question 17

What does G-CSF do?

Answer 17

Protect neutrophils from apoptosis and enhances their function
Control migration from marrow to the blood

Question 18

Filgrastim

Answer 18

Recombinant G-CSF
Treat severe neutropenia
NOT in prego

Question 19

Pegfilgrastim (Neulasta)

Answer 19

Pegylated recombinant G-CSF

Minimize glomerular filtration = increased duration of action

Question 20

Granulocyte Macrophage-CSF

Answer 20

Stimulates production and activty of all granulocytes and monocytes
Lineage specific receptor

Question 21

Sargramostim (Leukine)

Answer 21

Recombinant GM-CSF
Less glycosylated
Treats: after bone marrow transplant or neutropenia-induced chemotherapy

Question 22

Molgramotim

Answer 22

Non-glycosylated GM-CSF

Increased receptor binding

Question 23

Remove carb moiety =

Answer 23

increased the activity of GM-CSF

Question 24

What does IL11 do?

Answer 24

Stimulates hematopoiesis (megakarlocyte maturation)
Improve platelet recovery after chemo

Question 25

IL11 binds what to do what?

Answer 25

gp130 to initiate signal transduction pathway

Question 26

What is Oprelvekin (Neumega)?

Answer 26

Non-glycosylated

Stimulates megakaryocytopoiesis and thrombopoiesis

Question 27

Oprelvekin (Neumega) indicated for?

Answer 27

Prevent severe thrombocytopenia
Reduction of platelet transfusion
- Can cause some heart probs (elderly)

Question 28

What does Thrombopoietin do?

Answer 28

Stimulates the production and differentiation of megakaryocyte

Question 29

Romiplostim (Nplate) is?

Answer 29

Fusion protein analog of thrombopoietin (increase platelets)

Question 30

Romiplostim (Nplate) is indicated for?

Answer 30

Treatment for chronic idiopathic thrmbocytopenic purpura ITP)

Question 31

Eltrombopag (Promacta) is?

Answer 31

ORAL ONLY
Increases megokaryocytes to platelet
Treats: ITP and Hep C
HEPATOTOXICITY

Question 32

Erythropoietin (EPO) is?

Answer 32

Prevents apoptosis of erythroid precursor cells

Question 33

Erythropoietin can cause?

Answer 33

Iron deficiency, hypertension

Question 34

Epoietin Alpha (Epogen)

Answer 34

Taken with iron supps

Recombinant Erytropoietins