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SBL > Pharmacology of Anemia > Flashcards

Pharmacology of Anemia Flashcards

1
Q

What is the most common nutritional cause of anemia?

A

Iron deficiency Anemia

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2
Q

If Iron deficiency anemia is SEVERE, how do you treat it?

A

RBC transfusion

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3
Q

Is there a mechanism for elimination of excess iron?

A

No

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4
Q

What things can activate Hepcidin?

A

(Increased hepcidin = decreased absorption)

  • Iron
  • Inflammation
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5
Q

MCV < 80

A

Microcytic Anemia

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6
Q

Most common cause of Microcytic Anemia?

A

Decreased Iron

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7
Q

Diet items to increase iron?

A

Meat, fish, poultry

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8
Q

Oral treatment for Microcytic Anemia due to decreased iron?

A

200-400 mg of ferrous iron once a day with water/juice

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9
Q

200-400 mg of ____ once a day with water/juice treats Microcytic Anemia

A

Ferrous iron

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10
Q

What are the possible adverse side effects of oral treatment of iron for microcytic anemia?

A

Dark stools, nausea, constipation, heartburn, anorexia

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11
Q

Parenteral treatment for Microcytic Anemia due to decreased iron?

A

IV - LMW iron dextran or any complex with “ferric” or “iron”

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12
Q

IV - ______ can treat Microcytic Anemia

A

LMW iron dextran

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13
Q

What Parenteral treatment for Microcytic Anemia due to decreased iron can be given quickly?

A

Ferumoxytol

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14
Q

Is anaphylaxis common with Parenteral treatment for Microcytic Anemia?

A

No - similar side effects to the oral iron given

= heartburn, anorexia, dark stools, constipation, nausea

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15
Q

Who usually gets iron poisoning?

A

Children taking iron tablets

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16
Q

Cascade of symptoms for iron poisoning?

A
  • Necrotizing gastroenteritis, abdominal pain, vomiting
  • Shock, shortness of breath, lethargy
  • slight improvement
  • Coma/death
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17
Q

What is the treatment for iron poisoning?

A

Bowel irrigation and parenteral Deferoxamine

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18
Q

Parenteral Deferoxamine treats?

A

Iron poisoning

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19
Q

Deficiencies of _____ can cause Megaloblastic/Macrocytic Anemia

A

B12 and Folate

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20
Q

Sources of B12?

A

Meat products or fortified cereals

21
Q

Your body stores this vitamin so that it takes years to develop a deficiency

A

B12

22
Q

Causes of B12 deficiency?

A

Pernicious anemia
Gastrectomy
H. Pylori infection

23
Q

What analgesic inhaled during surgery can inactivate vitamin B12?

A

Nitrous oxide

24
Q

What are the symptoms of low B12?

A

Atrophic glossitis
NEURO - paresthesias, gait disturbances, weakness
Hyperpigmentation

25
Q

Atrophic glossitis, NEURO - paresthesias, gait problems and weakness, hyperpigmentation in combo with Megaloblastic anemia indicate?

A

B12 deficient

26
Q

Oral treatment (that works even for those with Pernicious anemia) for B12 deficiency that causes Megaloblastic anemia?

A

1-2 mg/day (500X daily need) that uses an alternative path for absorption so those with pernicious anemia can still take it even if they do not have intrinsic factor to absorb it

27
Q

When do you give Parenteral treatment for B12 deficiency that causes Megaloblastic anemia?

A

When NEURO symptoms are present

28
Q

Parenteral treatment for B12 deficiency?

A

Cyanocobalamin

- Adverse events rare

29
Q

2 usual causes of Folate deficiency that can cause Megaloblastic anemia?

A

Inadequate dietary intake

Alcoholism

30
Q

What are the symptoms of low folate?

A

Neural tube defects

Mouth ulcers

31
Q

Neural tube defects and mouth ulcers in combo with Megaloblastic anemia indicate?

A

Folate deficiency

32
Q

Treatment for Folate deficiency that causes Megaloblastic anemia?

A

Oral folate - 1mg/day for 4 months OR 1-5mg/day

33
Q

Higher doses of Folate can cause what side effects?

A

Hypoglycemia and Hypotension

34
Q

What is the treatment for Anemia of Chronic Disease?

A

Epoetin Alfa

35
Q

How is Epoetin Alfa administered and what does it treat?

A

IV or subcutaneous

- Treats Anemia of Chronic Disease and Anemia caused by chemotherapy

36
Q

How does Epoetin Alfa work?

A

Stimulates erythropoeisis and increases reticulocytes

37
Q

What is a drug that has a 3X longer half-life than Epoetin Alfa?

A

Darbepoetin Alfa (21 hour half life)

38
Q

The use of this drug was banned by the olympics

A

Epoetin Alfa

- Treats Anemia of Chronic Disease and Anemia due to Chemotherapy

39
Q

What is the ONLY treatment for Sickle Cell Anemia?

A

Hydroxyurea

40
Q

Hydroxyurea treats?

A

Sickle cell anemia

41
Q

How does Hydroxyurea work and how is it given?

A

Given Orally

- Unknown mechanism = INCREASES Fetal Hemoglobin

42
Q

This drug increased Fetal Hemoglobin

A

Hydroxyurea

43
Q

What drug treats Paroxysmal Nocturnal Hemoglobinuria?

A

Eculizumab

44
Q

Eculizumab treats?

A

PNH (paroxysmal nocturnal hemoglobinuria)

45
Q

How is Eculizumab administered to treat PNH?

A

IV - once per week for the first 4 weeks; then every 2 weeks after that

46
Q

How does Eculizumab work?

A

Blocks C5a from going to C5b and activating the complement MAC to lyse RBCs

47
Q

Possible side effects of taking Eculizumab?

A

Viral, meningococcal and respiratory infections
Headache, hypertension
Pain, anemia

48
Q

What are the possible side effects of taking Epoetin Alfa to treat Anemia of Chronic DIsease?

A

MI, tumor progression, death, stroke, VTE

SBL (48 decks)

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