Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Pharm for Anemias
Pharmacotherapy-II
| Question | Answer |
|---|---|
| 75% of all anemia’s are accounted for what | iron def, anemia chronic dz, associated w/ acute blood loss |
| Symptoms of acute onset anemia | tachy, lightheadedness, breathlessness |
| Symptoms of chronic onset anemia | fatigue, weakness, HA, vertigo, faintness, sensitivity to cold, loss of skin tone pallor |
| Initial lab evaluation for anemias | CBC w/ RBC, retic count, FOB |
| Nl ranges for Hgb and hematocrit | M14-17.5, 12.3-15.3 M42-50, F: 36-45 |
| Nl MCV | 80-100 |
| Nl iron | M: 45-160 F: 30-150 |
| Nl ferritin | <10-20 |
| Nl retic count | M: .5-1.5 F: .5-2.5 |
| What is iron essential for | Hgb synthesis therefore O2 transport |
| Causes of iron deficiency anemia | inadequate dietary intake, inadequate aborption, ↑iron demands, blood loss, list some of each |
| What are signs of iron def | koilonychias, angular stomatitis/glossitis, PICA |
| Koilonychias | spooning of the nails |
| What happens w/ iron def in children and adolescents | affects cognitive fxn and achievement |
| Lab findings with iron def anemia | ↓serum iron, ferritin, High TIBC, low Hgb and Hct in later stages, microcytic anemia |
| What ↑ absorption on nonheme iron | gastric and ascorbic acid |
| What iron is more easily absorbed | iron in meat, fish, and poultry |
| What can ↓ iron absorption | milk and tea |
| Tx of iron def anemia | find underlying cause, dietary supplements, therapeutic iron preparations oral or paraenteral, transfusions |
| Where is iron absorbed | max in duadnum, rest in small intestine ( don’t want extended release) |
| Recommended iron supplementation | 200mg elemental iron/day, in 2-3 doses (best absorbed w/o food or other meds) |
| When is iron better tolerated | smaller more frequent doses |
| MC iron supplementation | ferrous sulfate 325mg tablet PO tid (20%iron) |
| AE’s iron supplementation | GI, discoloration of feces (black), abd pain, heartburn, constipation, N/V |
| Absecence of AE’s may indicate what | non adhearance |
| If SE’s intolerable,what can they do | take iron w/ meals (↓daily dose to 110-120mg elemental Fe) |
| Monitoring of iron supplementation | AE’, 3wks should raise Hgb 2g/dL |
| Why would tx fail | nonadhearence, misdiagnosis, malabsorption, blood loss, anemia-inducing dz states |
| What is the gold standard for parenteral iron supplementation | iron dextran 50mg IV/IM by Z-track |
| AE’s of Iron dextran | arthralgias, myalgias,flushing, malaise, fever, allergic rxns (rarely anaphylaxis) |
| What should we do prior to giving full iron dextrose dose | test dose, 25mg iv/im observe >1hr before administering remainder of dose, have IV epi ready |
| What is B12 | water soluble vitamin, obtained by ingestion of meat and dairy products, |
| Fxns of B12 | needed for DNA synthesis, metabolic rxns w/ folic acid, |
| Daily requirements of B12 | 2-2.6mg |
| 3 causes of B12 def | inadequate intake, ↓ absorption, inadequate utilization |
| s/s of B12 def | neurologic sxs, glossitis, dysphagia, anorexia |
| lab findings of B12 def | MCV >100, retic count, B12 levels and Hbg low |
| pernicious anemia | Vit B12 def d/t intrinsic factor def |
| three ways to tx B12 def | oral (1-2mg), parenteral:1000mcg q week , nasal spray: do not administer within 1 hr hot food/beverage |
| monitoring of B12 def tx | retic count w/I 2-3days, CBC and B12 usually back w/I 1-2m |
| what may be greater during B12 initiation | need for iron |
| AE’s ofB12 tx | hyperuricemia, hypokalemia, rebound thrombocytosis, fluid retention, anaphalaxis |
| Where can we find folic acid | fresh fruits, veggies, yeast, mushrooms, animal organs |
| What is folic acid | heat-labile vit. Necessary for production of nucleic acids, proteins, amino acids, purines, and thymine |
| What are folate antagonists | MTX, pentamidine trimethoprim, triamterene |
| What are drugs that ↓ folic acid | inducers: phenytoin, phenobarbital, primidone |
| Sxs of folic acid def | similar to B12 but NO neuro sxs (slow onset) |
| What is tx for folic acid def | 1-5mg po qdx4m |
| What is pre contraception for folic acid | 400-1000mcg qd |
| When will Hbg normalize w/ tx | within 2m |
| What is the anemia mechanism with anemia of chronic dz | w/ ↑ need of metabolism and other things, RBC life shortene |
| What do cytokines do | may inhibit production or action of erythropoietin or inhibit RBC production |
| Lab findings w/ Anemia chronic dz | serum iron ↓, ferritin nl or ↑, iron binding capacity nl or ↓ |
| Tx of anemia chronic dz | tx underlyin d/o erythropoietin stimulating agents, |
| AE’s of erthyropoeitin | DBP elevation, fatigue, HA, fever, edema, CP, N/D/V |
Created by:
becker15
Popular Pharmacology sets