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Pharm - Anemia

Saba - Basic Sciences - Semester 4 - Pharm - Blk3 - Lect04

QuestionAnswer
Anemia – Definition This is a deficiency in the Oxygen-carrying capacity of erythrocytes
Anemia – Causes (-) hematopoetic nutritl factors is cause for this condn, as well as leukopenia and thrombocytopenia. (-) hematopoetic growth factors also causes as they regulate proliferation and differentiation of progenitor bl cells in bone marrow.
Anemia – Causes - Hematopoetic Nutritional Factors (3) Iron, Vitamin B12 and Folic acid are hematopoetic factors whose deficiencies results in respective types of this condition, along with leukopenia and thrombocyopenia
Anemia – Causes - Hematopoetic Nutritional Factors - B12 This hematopoetic factor is also responsible for cell replication (DNA synthesis) and myelin synthesis, required for neuronal growth.
Anemia – Causes - Hematopoetic Growth Factors These factors include Erythropoetin, Myeloid Growth Factors and Megakaryocyte Growth Factors
Anemia – Causes - Hematopoetic Growth Factors - Megakaryocyte Growth Factor This is also known as IL-11
Anemia – Iron Deficiency - Signs & Symptoms (5) Signs and symptoms of this condition include pallor, fatigue, dizziness, dyspnea, tachycardia.
Anemia – Iron Deficiency - Microcytic Hypochromic - Causes (4) This particular type of anemia is d/t Bleeding, Dietary Deficiency, Malabsorption, Increased Fe demands in (pregnancy/lactation)
Anemia – Iron Deficiency - Treatments This condition is treated with ferrous salts, either by parenterally and orally
Anemia – Iron Deficiency -Treatments - Ferrous Salts - Oral - Drug List (3) This treatment type include Ferrous sulfonate, (20%) Ferrous gluconate (12%), Ferrous fumarate (33%)
Iron Deficiency Anemia – Treatments - Ferrous Salts – Oral - Pharmacokinetics Ferrous forms of treatment for this disease are more easily absorbed than ferric, or in conjunction w/ ascorbic acid. Best taken on an empty stomach. Increased absoprtion in deficiency conditions. Requires 3-6 months to replenish stores.
Iron Deficiency Anemia – Treatments - Ferrous Salts – Oral – Adverse Reactions (2) Adverse reactions to this kind of disease tx include GI upset***: nausea, epigastric discomfort , abdominal cramps, constipation and diarrhea (better to administer w/ food, altho this reduce absorption), and Black stool d/t iron color.
Anemia – Iron Deficiency -Treatments - Ferrous Salts - Parenteral - Drug List (3) This treatment type include iron dextran (MC - IM, or IV), sucrose & sodium gluconate complexes
Anemia – Iron Deficiency - Treatments - Ferrous Salts – Parenteral Iron Therapy – Indications (3) This treatment is indicated for patients who are unable to tolerate oral preparations d/t ADR or lack of absorption, or if they have sustained extensive, chronic blood loss.
Anemia – Iron Deficiency -Treatments - Ferrous Salts – Parenteral Iron Therapy – Adverse Effects (5) Adverse effects of this drug incl 1)HSRs: bronchospasm, urticaria & anaphylaxis (test dose reqd), 2) Pain, inflammn @ injectn site, 3) Browning of skin by IM inj (use Z-track), and 4) Fever, arthralgia, nausea, vomiting, flushing, and 5) toxicity possible
Anemia – Iron Deficiency -Treatments - Ferrous Salts – Adverse Effects - Acute Iron Toxicity (4) This condition can occur in tx of anemia, R/I 1) Necrotizing gastroenteritis, 2) Vomiting, abdominal cramps, bloody diarrhea, 3) Shock, lethargy, dyspnea, 4)Metabolic acidosis, coma and death, particularly in children
Anemia – Iron Deficiency -Treatments - Ferrous Salts – Adverse Effects - Acute Iron Toxicity - Antidotes This condition is treated w 1)supportive therapy for GI bleeding, metabolic acidosis and shock (sodium bicarbonate), 2)Whole bowel irrigation to flush out unabsorbed pills, and 3) Deferoxamine – (NOT activated charcoal)
Anemia – Iron Deficiency - Treatments - Ferrous Salts – Adverse Effects - Acute Iron Toxicity - Antidotes - Deferoxamine This antidote for iron toxicity is a chelating agent: Increases Iron excretion.
Anemia - Megaloblastic - Causes This type of anemia results from deficiency in Folic acid or Vitamin B12. Supplementation of either can be used to tx.
Anemia - Megaloblastic - B12 Deficiency - Effects This condition results in methylfoltate trap that manifests as neurological problems (lack of myelin d/t lack of methionine
Anemia - Megaloblastic - B12 Deficiency - Effects - Methylfolate Trap This defic state d/t the decreased conversion of N-methyltetrahydrofolate to tetrahydrofolate and its cofactors lead to (-) DNA synthesis in rapidly dividing cells. NMTHF accummulates, and reduced methionine synthesis leads to neurological problems
Anemia - Megaloblastic - Tx - Folic Acid – Indications (3) This anemia tx is indicated in cases of 1) Dietary deficiency, 2) decreased absorption, or 3) prophylactially During pregnancy to prevent anemia & neural tube defects (spina bifida).
Anemia - Megaloblastic - Tx - Vitamin B12 – Preparations (2) Types of this Tx include cyanocobalamin and hydroxocobalamin. 100-1000 micrograms - daily for 1-2weeks initially, once in month by IM inj for lifelong.
Anemia - Megaloblastic - Tx - Vitamin B12 – Preparations - Hydroxocobalamin This form of B12 is preferred for tx. It is highly pr- bound and remains in circulation for longer time.
Anemia - Megaloblastic - Tx - Vitamin B12 – Indications (2) This anemia tx is indicated in cases of 1) Dietary deficiency & malabsorption*, and 2) Pernicious anemia
Anemia - Megaloblastic - Tx - Vitamin B12 – Indications - Pernicious Anemia This condition results from a deficiency of intrinsic factor secretion by the gastric mucosal cells
Anemia - Megaloblastic - Tx - Vitamin B12 – Misdiagnosis If this condition is misdiagnosed and treated with folic acid instead, all but the neurological symptoms will be corrected
Anemia - Megaloblastic - Tx - Vitamin B12 – Deficiency – Neurological Problems Administration of Folic acid in the setting of Vitamin B12 deficiency will not prevent Neurologic manifestations even though it will largely correct the anemia caused by the Vitamin B12 deficiency.
Anemia - Growth Factor Def - Txs Treatments for anemias d/t hematopoetic growth factor deficiencies include epoetin, and recombinant myeloid and megakaryocyte growth factors (RMGF, RMkGF)
Anemia - Growth Factor Def - Txs - Epoetin This is a recombinant human erythropoeitin that stimulates erythroid proliferation & differentiation. IV/IM inj. It is banned by the IOC for improving oxygen carrying capacity.
Anemia - Growth Factor Def - Txs - Epoetin - Indications This tx is used in anemias d/t 1) renal failure, 2) primary bone marrow disorders, 3) chemo-induced, 4) zidovudine-induced
Anemia - Growth Factor Def - Txs - RMGFs - drug list (2) This type of anemia tx includes Filgrastim (better tolerated and MC used), and Sargramostim
Anemia - Growth Factor Def - Txs - RMGFs - Filgrastim, This is a recombinant human granulocyte CSF that stimulates the proliferation and differentials of neutrophil progenitors
Anemia - Growth Factor Def - Txs - RMGFs- Filgrastim - Adverse Effects This drug for anemia induces bone pain
Anemia - Growth Factor Def - Txs - RMGFs - Sargramostim This is a recombinant human granulocyte - macrophage CSF that stimulates the proliferation and differentials of granulocyte, erythroid and megakaryocyte progenitors
Anemia - Growth Factor Def - Txs - RMGFs - Sargramostim - Adverse Effects This drug for anemia induces bone pain, as well as Fever, malaise, arthralgia, capillary leak, peripheral edema, pleural or pericardial effusions, particular to rGM-CSF
Anemia - Growth Factor Def - Txs - RMGFs - Indications These drugs are indicated in the tx of 1) neutropenia d/t cancer chemo (reduces febrile neutropenia and reqmt of antibiotics, 2) congenital neutropenia and 3) autologous stem cell transplant
Anemia - Growth Factor Def - Txs - RMKGFs - Drug List Oprelvekin is this class of drugs, used in the treatment of anemia
Anemia - Growth Factor Def - Txs - RMKGFs - Oprelvekin - Effects This recombinant form of IL-11 works b/c it 1) stimulates growth of multiple lymphoid and myeloid cells, as well as megakaryocyte progenitors, increasing the number of neutrophils and platelets
Anemia - Growth Factor Def - Txs - RMKGFs - Oprelvekin - indications This drug is indicated in the prevention of thrombocytopenia induced by cytotoxic chemo
Created by: mprentic12