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AntiAnemicDrugs
lecture 16 thorpe
| Question | Answer |
|---|---|
| Niferex-150 | new ferric polysaccharide complex that is better tolerated than the older ferrous preps, less side effects |
| traditional oral iron preparations | usually ferrous salts that are converted after ingestion to ferric, absorbable version; have mod side effects |
| causes of iron-deficiency | preg and not taking enough iron, bleeding from GI tract or uterus, inadequate dietary intake (mostly in developing countries), interference with iron absorption as in duodenal or jejunal resection or tropical sprue |
| reason for weakness and lethargy in iron-deficient anemia | insufficient iron for myoglobin, cytochromes, peroxidases, xanthine oxidase and alpha-glycerophosphate oxidases |
| substance added with ferrous oral supplements to help with absorption | vitamin C (ascorbate) |
| given to replenish iron stores in a single IV infusion (not without its toxic side effects like allergic rxns) | iron dextran, used in cases of severe iron deficiency or in those who can't tolerate oral iron |
| chelator of choice for iron poisoning | deferoxamine (IM or IV) |
| currently preferred agent for parenteral administration of iron | sodium ferric gluconate |
| notable adverse effect of iron sucrose | renal damage |
| amt of time it takes to replenish body iron stores using oral therapy | from 1 to up to 6 months |
| body stores of folate or vit B12 are least? | folate supplies are least thus deficiency in folate causes megaloblastic anemia first |
| most common form of vit B12 deficiency | pernicious anemia, intrinsic factor that is secreted by parietal cells in the stomach is absent causing decreased absorption of vit B12 |
| why lack of folate doesn't cause demyelination like vit B12 deficiency | folate is used as a methyl donor for DNA synthesis but there are other methyl donors like S-adenosylmethionine |
| forms of vit B12 that are taken IM or SC | prodrugs cyanocobalamin (IM once per month) and hydroxocobalamin (IM once per 3 mo) |
| almacen of vit B12 & folate in body; how are levels regulated? | liver stores vit B12 and folate; enterohepatic circulation allow for constant levels being available to tissues |
| mechanism of folic acid use in body | ingested orally or given IV, converted to (CH3)THF in GI tract, in tissues it's converted to THF using vit B12-dependent mechanism. THF is used in DNA synthesis |
| folate is used to treat | megaloblastic anemia secondary to folate deficiency, preg women to keep them from getting anemia and protect fetus from having myelomeningoceles or childhood ALL |
| erythropoietin | endogenous protein secreted by kidney, regulated by HIF-1alpha but itself regulates proliferation of committed erythroid progenitors through BFU-E and CFU-E |
| causes of folate deficiency | alcoholism, not eating green leaf vegetables, preg, tropical sprue, drug-induced folate deficiency (taking methotrexate) |
| epoetin alfa | recombinant erythropoietin with short half-life, given SC 1-3x/week |
| darbepoetin alfa | heavily glycosylated recombinant erythropoietin with half-life such that it's administered SC q1-3 wks |
| methoxy polyethylene glycol-epoetin beta | continuous erythropoietin receptor activator (CERA), given SC once per month |
| adverse effects of erythropoietins | don't give to Hb > 12 b/c it's associated with increased thromboembolic events, can accelerate tumor growth by providing more O2 to tissues, HTN seen in 20-30% of pts |
| indications for erythropoietins | anemia of CRF, marrow depression or HIV therapy, prematurity or cardiac/ortho perioperative period |
Created by:
sirprakes
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