Pharmacology of Anemia and Hematopoetic GF

Question 1

Iron (oral)

Answer 1

• Hypochromic Microcytic anemia
• food inhibit absorption
• GI irritation

Question 2

Iron (parenteral)

Answer 2

• Hypochromic microcytic anemia

- risk of anaphalaxis

Question 3

Vitamin B12

Answer 3

• Megaloblastic anemia
• Glossitis
• neuropsychiatric requires parenteral

Question 4

Folate

Answer 4

• Megaloblastic anemia
• Neural tube defect in fetus
• Mouth ulcers
• Neuropsychiatric

Question 5

Epoetin alfa

Answer 5

• Anemia of chronic renal dz
• cancer chemotherapy
• identical to EPO
• RBC count normal in 10 days

Question 6

Hydroxyurea

Answer 6

• Sickle cell anemia
• Increases levels of fetal hemoglobin
• targets ribonucleotide reductase, results in S-phase cell cycle arrest

Question 7

Eculizumab

Answer 7

• Paroxysmal nocturnal hemoglobinuria
• binds complement C5, inhibits its cleavage to C5a/b
• Very effective, very expensive
• many side effects, infection, msk pain, headache

Question 8

Filgrastim

Answer 8

• Neutropenia
• identical to G-CSF (granulocyte colony stimulating factor)
• allergy, bone pain

Question 9

Pegfilgrastim

Answer 9

• Neutropenia

- just a longer lasting filgrastim d/t conjugation w/ PEG

Question 10

Sargramostim

Answer 10

• Neutropenia
• identical to GM-CSF (granulocyte macrophage)
• increases neutrophils, eosinophils, macrophages
• used in bone marrow tranplant
• gasping baby syndrome

Question 11

Plerixafor

Answer 11

• Neutropenia
• CXCR4 receptor PARTIAL agonist
• mobilizes hematopoetic SC from bone marrow
• orphan drug

Question 12

Oprelvekin

Answer 12

• Thrombocytopenia
• IL-11
• promotes formation of megakaryocytes
• edema

Question 13

Romiplostim

Answer 13

• Idopathic thrombocytopenic purpura (ITP)

- peptibody that binds to TPO receptor

Question 14

Eltrombopag

Answer 14

• Idopathic thrombocytopenic purpura (ITP)
• liver cirrhosis
• non-peptide TPO receptor agonist