Topic 12 Anemia

Question 1

Anemia Therapeutics

Answer 1

Iron
B12
Folic Acid (B9)
Erythropoietin (Epogen, Procrit)

Question 2

Why is Iron a treatment of Anemia?

Answer 2

Required for the hemoglobin molecule to carry
O₂
Iron deficiency results from inadequate iron stores &/or intake.

Question 3

Iron is stored in what?

Answer 3

Stored in intestinal mucosal cells as ferritin.

Question 4

Oral Iron supplement adverse effects?

Answer 4

Injections HURT!

Oral iron supplements can cause “GI upset”

Question 5

Iron deficiency anemia classically causes what kind of anemia?

Answer 5

hypochromic, microcytic anemia

Question 6

Folate (B9) deficiencies are caused by what?

Answer 6

pregnancy, lactation, intestinal pathology (Crohn’s Disease, etc.) preventing absorption, alcoholism, certain drugs.
Folate is require for DNA synthesis

Question 7

Folate deficiency anemia classically causes what type of anemia

Answer 7

megaloblastic anemia

Question 8

Most common cause of deficiency is what?

Answer 8

poor B₁₂ absorption aka “pernicious anemia”

Question 9

pernicious anemia

Answer 9

poor B₁₂ absorption

Question 10

B₁₂ deficiency also causes what type of anemia

Answer 10

megaloblastic anemia

Question 11

Therapies for megaloblastic anemia

Answer 11

B₁₂ and Folate

Question 12

Epogen and Procrit (Erythropoietin) are what chemically?

Answer 12

Both are synthetic forms of erythropoietin-alfa

•Both have identical protein structure and vary in their glycosylation

Question 13

Darbepotin (Aranesp)

Answer 13

is a longer-acting cousin of Epogen and is “albumin-free”
•Part of a comprehensive blood. conservation/blood management program.
•Require week(s) to “kick in” bone marrow so not appropriate for acute blood loss.
•Usually given with iron

Question 14

Darbepotin

Answer 14

(Aranesp)

Question 15

Darbepotin (Aranesp) side affects?

Answer 15

High potential for abuse!
–Stroke
–Increased tumor risk
–Thromboembolic events
–Severe HTN–Death

Question 16

Sickle cell drugs?

Answer 16

Hydroxyurea (Hydrea, Droxia)

Pentoxifylline (Trental)

Question 17

Hydroxyurea

Answer 17

Hydrea, Droxia

Sickle cell drugs

Question 18

Pentoxifylline

Answer 18

Trental

Sickle cell drugs

Question 19

Hydroxyurea (Hydrea, Droxia) - how does it work?

Answer 19

Fairly effective in preventing painful acute
“crises” associated with sickling claudication.
*Causes sickle cell hemoglobin (HbS) to get diluted by an increased production of fetal hemoglobin (HbF) particularly when used with epo-alfa

Question 20

Claudication

Answer 20

Pain caused by too little blood flow

Question 21

Pentoxifylline is what kind of modifier

Answer 21

rheologic modifier!

-It increases the “flexibility” of RBC’s so they are less likely to clog capillaries

Question 22

Pentoxyifylline does what?

Answer 22

Decreases blood viscosity so interesting future possibilities…TIA, strokes, Raynaud’s, diabetic ulcers, etc