Pharmacology of Agents Used in Anemia, Cytopenias, & Hematopoietic Growth Disorders

Question 1

Anemia caused by B12 deficiency due to IF autoantibodies is called…?

Answer 1

Pernicious anemia

Question 2

This is the most common oral iron supplement to treat iron deficiency anemia?

Answer 2

Ferrous sulfate

Question 3

True/False. Activated charcoal is effective in treating iron toxicity.

Answer 3

False - deferoxamine must be used to chelate iron in the blood

Question 4

This drug is used as an iron chelator to treat cases of acute iron toxicity.

Answer 4

Deferoxamine

Question 5

Reduced EPO production due to renal failure or chemotherapy requires treatment with this drug.

Answer 5

Epoetin alfa

Question 6

What drug is used as a secondary treatment of thrombocytopenia due to cancer chemotherapy?

Answer 6

Oprelvekin (recombinant IL-11)

Question 7

This drug mimics G-CSF to mobilize homeopathic stem cells and stimulate production of neutrophils.

Answer 7

Filgrastim

Question 8

This molecule is lacking in patients who underwent gastrectomy and impairs iron absorption by the gut.

Answer 8

Intrinsic factor secreted by parietal cells

Question 9

These drugs are indicated to treat chronic immune thrombocytopenia.

Answer 9

Romiplostim, Eltrombopag, Fostamatibib

Question 10

What is the purpose of folic acid supplementation?

Answer 10

Prevent megaloblastic anemia caused by folate deficiency and neural tube defects in developing embryos

Question 11

Folate and B12 deficiencies cause megaloblastic anemia. How can the two be differentiated based upon clinical presentation?

Answer 11

B12 deficiency will present with neurological deficits, whereas folate deficiency will not

Question 12

This drug is used to treat vitamin B12 deficiency causing megaloblastic anemia.

Answer 12

Hydroxocobalamin

Question 13

What is the MOA of fostamatinib?

Answer 13

SYK tyrosine kinase inhibitor use to treat chronic immune thrombocytopenia by decreasing antibody-mediated platelet destruction

Question 14

Alcoholism is most associated with what cause of megaloblastic anemia?

Answer 14

Folate deficiency

Question 15

Romiplostim and eltrombopag are both TPO receptor agnoists to treat chronic immune thrombocytopenia. How do the drugs differ?

Answer 15

Romiplostim is administered parentally, whereas eltrombopag is administered orally

Question 16

What ADRs are associated with epoetin alfa?

Answer 16

Hypertension, thrombosis, stroke (due to significantly increased hemoglobin)

Question 17

Iron is absorbed in what form?

Answer 17

Ferrous (Fe2+) - conversion from the ferric form occurs by gastric acid

Question 18

What are the most common nutritional causes of anemia?

Answer 18

Deficiencies of iron, folate, Vitamin B12

Question 19

What hormone inhibits hepcidin?

Answer 19

Erythroferrone

Question 20

A patient with kidney disease is diagnosed with iron deficiency anemia. In addition to iron supplementation, what other supplement must be provided?

Answer 20

Erythropoietin - synthesis by the kidney is decreased with kidney disease

Question 21

This drug mimics GM-CSF and also stimulates the function of mature neutrophils.

Answer 21

Sargramostim

Question 22

What is the risk of treating megaloblastic anemia with folate supplementation, without confirming the true cause of anemia?

Answer 22

Folate supplementation will correct the megaloblastic anemia, but mask any B12 deficiency. The result is the progression of neurological degeneration

Question 23

What significant ADRs are associated with sargramostim?

Answer 23

Capillary leak syndrome

Question 24

EPO supplements carry the risk of functional iron deficiency. What does this mean?

Answer 24

EPO stimulates hematopoiesis and could lead to reduced iron stores. EPO drugs must be supplements with iron and hemoglobin levels closely monitored.