Anemia

Front 1

Ferrous sulfate

% elemental iron

Back 1

20%

Front 2

Ferrous gluconate

% elemental Fe

Back 2

12%

Front 3

Ferrous fumarate

% elemental Fe

Back 3

33%

Front 4

Ferrlecit

Back 4

sodium ferric gluconate

parenteral

Front 5

DDIs that decrease iron absorption

Back 5

antacids/H2RAs/PPIs
TCNs, cholestyramine
*Separate from iron by 2hrs

Front 6

DDIs that results in chelation with iron
Decreased efficacy, absorption

Back 6

levodopa, penicillamine
Forms complex with FQs
Decreases mycophenolate abs
Food decreases Fe abs by 50% (take empty stomach if tolerate, or else take with OJ to double absorption)
Fe decreases efficacy of methyldopa, synthroid

Front 7

Feraheme

Back 7

ferumoxytol
elemental Fe 30mg/ml
(1 vial=17ml=510mg IV push then rep in 3-8 days)
-indxn IDA in adults with CKD
CI in anemia not caused by Fe deficiency
*Alters MRI imaging studies

Front 8

Desferal

Back 8

deferoxamine
IM 500-1000mg daily
IV: 2g infusion (</= 15mg/kg/hr) w/each unit of blood transfused (NTE 1gm in absence of transfusion)
-SQ 20-40mg/kg/d over 8-24hr via CIV pump

Hint 8

Use w/in 3hrs s/p + sterile H20
CI in severe renal dz/anuria
DDIs Vit C (NTE 200mg/d), prochlorperazine, gallium 67

Front 9

Exjade

BBW

Back 9

deferasirox
PO 20mg/kg/d empty stomach 30min ac; max dose 40mg/kg/d
BBW: hepatic/renal imp, GI hemorrhage

Hint 9

preg cat B

Note: Iron overload by def >300mcg/dL (300mcg/ml)

Front 10

Epogen
Procrit
BBW

Back 10

epoetin alfa IV, SQ
ADR: HTN (DBP)/edema/Sz risk highest 1st 90days)
BBW: risk death/CV events in pts w/ Hgb >12g/dL, CA
* Goal maint: 10-12g/dL

Hint 10

indxn: CRF, ZDV tx HIV pts, CA pts on CT, reduction of allogenic bld transfusion in sx pts

Front 11

Aranesp
BBW

Back 11

darbopoetin IV,SQ
Dosing: mcg/kg wkly
CI: uncontrolled HTN, hypersenstivity: alb/polysorbate 80

Hint 11

indxn: CRF +/- HD, CIA
prefilled syringes: 25-100mcg/0.3-1ml)
t1/2: 3x longer vs epo

Front 12

Nascobal

Calomist

Back 12

cyanocobalamin
Nascobal: 500mcg (1 spray) in ONE nostril once wkly
Calomist: 50mcg (=1 spray) to 2 sprays EACH nostril DAILY

Hint 12

intranal formulation advantage for pt's w/ dysphagia

Note: oral vit b12: not indicated pernicious anemia d/t poor absorption

Front 13

Cyanocobalamin (vit b12)
dosing for pernicious anemia

Back 13

PN: 100mcg daily x 7d, then 100mcg alternate days for 7 doses, then every 3-4 days for 2-3 wks, then 100mcg qmonth for life (maintenance dose)

B-12 def: IM/SubQ:30mcg/d x 5-10d then maintenance: 100-200mcg/month

Hint 13

IV, IM, SQ
Preferred route of adm (IM/SQ) d/t rapid elim/risk of anaphylaxis with IV

Front 14

Neupogen
Neulasta
Leukine

ADRs & Contraindications

Back 14

filgrastim: hypersensitivity to e.coli proteins, DNU 24-48hr bef or w/in 24hr after CT
ADR: bone pain/rash/fever

pegfilgrasitim: DNU if < 45kg

sargramostim: hypersensitivity to yeast products, concurrent chemo/radiation tx, formulation 500mcg/ml contains benzyl alcohol
ADR: hypoBP, syncope,HA, diarrhea, fever,myopathy

Hint 14

Neutropenia G-CSF treatments
-Infection risk increases rapidly w/ANC <500 cell/mm3

Front 15

Neumega IL-11

Back 15

oprelvekin
SQ 50mcg daily x 10-21d
renal adjust crcl<30
ADR:tachy,edema,arrhythmia,n/v,anaphylaxis

Hint 15

indxn: prevention of severe thrombocytopenia
moa: thrombopoietic GF

Front 16

Droxia

Hydrea

Back 16

hydroxyurea
15mg/kg/daily, may inc by 5mg/kg/d Q12wks to max 35mg/kg/day
Renal adjust: Crcl <60

Hint 16

CI: severe BMS
BBW: secondary leukemia
*hazardous agent, mutagenic: use gloves for handling!
*HIV pts higher risk of pancreatitis, hepatotoxicity/failure,and severe peripheral neuropathy