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37 Cards in this Set
- Front
- Back
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Blood transporter of Fe3+ |
Transferrin |
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Cellular storage protein for Fe3+ |
Ferritin |
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Breakdown product of Fe |
Hemosiderin |
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Most soluble state of Fe |
Fe2+ (found in Hem-Iron in red meat) |
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Ferritin and Transferrin Receptor levels when Fe is in surplus |
Increased Ferritin Decreased Transferrin Receptor |
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Ferritin and Transferrin Receptor levels when Fe supply drops |
Decreased Ferritin Increased Transferrin Receptor |
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Oral Fe prepartations |
Ferrous (Fe2+) fumarate/gluconate/sulfate-hydrated/sulfate-anhydrous
Carbonyl Fe (decreased toxicity risk) |
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What type of conditions should Oral Fe preparations be taken? |
Acidic stomach (NO H+ PUMP INHIBITORS) |
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Parental Fe Prepartion indicated for Fe-deficient anemia when oral formulation is contraindicated |
Iron Dextran - INFeD (low molecular weight) is preferred due to decreased anaphylaxsis risk |
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Parental Fe Prepartions indicated for chronic kidney disease |
Sodium-Ferric Gluconate Complex
Ferumoxytol |
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Side Effects of Fe Preparations |
Stomach Pain, Bloody black stools & GI Symp
*oral doses spread out decreases SE *can take w/ food to decrease SE, but this decreases absorption |
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Side effects of Parental Fe preps |
Anaphylaxis - especially dextraxn formations Hypotension - prevent by giving infusion slowly |
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Drugs that decrease Fe absorptions |
anatacids Quinolones Tetracyclines Thyroid Drugs |
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Drugs that increase Fe absorption |
ascorbic acid |
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Trx for Fe toxicity (coma/shock/seizures) |
IV Deferoxamine (chelation therapy) Carbonate Stomach lavage |
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A deficiency in B12 while cause a build-up of what 2 precursors? |
Methylmalonic acid Homocysteine |
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What special element is found in B12 that is used in DNA synthesis to convert methyl-THF to THF? |
Cobalt (Cobalamin) |
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Why is it important to not treat megablasic anemia with folate only? |
Folate will fix megablastic effects due to it tying into the B12 pathway for DNA synthesis but will NOT address the neuro effects caused exclusively by B12 deficiencies! |
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What are the dietary sources of B12? |
Dairy and organ meat (ie liver) |
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IM medication for B12 deficiency that carries a SE of hypokalemia, but is still the most common preparation used |
Cyanocobalamin (*note - oral and intranasal forms available) |
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IM medication for B12 deficiency that is protein bound for a longer 1/2 life but can cause AB's against transcobalamin-B12 complex to form |
Hydroxocobalamin |
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What are the 3 inactive forms of Folic acid |
Folate Pteroylglutamic acid Folic acid (*all activated after absorption) |
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What are the dietary sources of Folates and what form is the folate in? |
Liver, veges, grains, fruit *Present as reduced polyglutamates |
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How are folates absorbed? |
All but one of the Glu's are removed before absorption in prox small intestine then added back on inside tissue |
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What feature of folic acids metabolism causes it to have an extended 1/2 life? |
enterohepatic cycle (metabolized by liver, reabosorbed by gut) |
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What 2 rxns are THF active in the transfer of one-carbon units? |
(1) conversion of homocysteine to methionine (important b/c excess homocys is a CV risk!)
(2) synthesis of thymidylate |
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give 3 ways a folate def. can develop |
(1) dietary def. (can be due to EtOH or GI malabsorption)
(2) Rx that inhibit Dihyrdofolate reductase (ie methotrexate)
(3) Rx that block folate storage/absorption (ie phenytoin) |
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What is the risk of long-term therapy w/ folate? |
may increase risk of colon/lung/prostate cancer |
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Hematopoietic growth factor naturally produced by kidney in response to hypoxia that is isolated for clinical use |
Epoetin alfa |
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Hematopoietic growth factor that is glycosylated to increase 1/2 life and is often abused by athletes |
Darbepoetin alfa |
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What are the 2 main clinical indications for ESA (erythropoiesis stimulating agents) |
(1) Renal failure pts w/ anemia (must supplement w/ Fe as well)
(2) Anemia due to chemo |
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Give 3 SE for ESA (erythropoiesis stimulating agents) |
(1) rapid increase in Hct and Hb
(2) Hypertension
(3) Thrombotic complications (coadminister w/ blood thinner) |
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A G-CSF that stimulates neutrophil production in cancer pts at risk for infection and to shorten the duration of neutropenia w/ BM transplant |
Filgrastin |
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A GM-CSF used mainly to increase neutrophils for recovery after myelosuppressive chme and BM transplant |
Sargramostim |
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A recombinant IL-11 used to treat thrombocytopenia due to myelosuppressive cancer-chemo |
Oprelvekin |
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A Thrombopoietin Receptor Peptide Agonist used to treat idiopathic thrombocytopenic purpura |
Romiplostim |
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A Thrombopoietin Receptor Agonist used to treat idiopathic thrombocytopenic purpura that binds the transmembrane domain of the receptor to activate it |
Eltrombopag |
