• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/32

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

32 Cards in this Set

  • Front
  • Back
Which form of iron is able to be absorbed?

Which form is used in the body?
Fe2+ (ferrous) is absorbed

Fe3+ (ferric) is used
What is the sequence of events in iron deficiency anemia?

What is the sequence of events in treatment?
1. Depletion of iron stores
2. Iron deficient erythropoiesis
3. Decreased hemoglobin and microcytosis
4. True iron anemia (vs. inflammatory)

With treatment, the steps are reversed. Recovery
Which oral iron preparations are 12-33% elemental iron?
Ferrous sulfate (20-30%)
Ferrous gluconate (12%)
Ferrous fumarate (33%)
Which oral iron preparations are 100% elemental iron?

---> expensive!
polysaccharide iron complex
carbonyl iron
What is the value of sustained release iron formulations?
pretty much nothing

they may have fewer SE, but probably only because of lower absorption
Which parenteral iron preparation uses a preservative?
sodium ferric gluconate
What are the four parenteral iron preparations?
ferumoxytol
sodium ferric gluconate
iron dextran
iron sucrose
Which parenteral iron formulation is suitable for patients with CKD?
ferumoxytol
Which parenteral iron formulation is suitable for patients taking erythropoietin therapy?
sodium ferric gluconate
Which parenteral iron formulation is suitable for patients taking epoetin alfa therapy?
iron sucrose
Which parenteral iron preparations has a black box warnings?
iron dextran,
iron sucrose

- anaphylaxis
Which parenteral iron is available in IM formulation?
iron dextran
What are the common SE of ferumoxytol?
diarrhea, constipation,
nausea, dizziness, hypotension,
peripheral edema
What are the common SE of sodium ferric gluconate?
cramps, N&V,
flushing, rash,
hypotension,
pruritis (itchy skin)
What are the common SE of iron dextran?
pain/browning at site,
flushing, fever, chills,
hypotension, myalgia,
anaphylaxis
What are the common SE of iron sucrose?
leg cramps,
hypotension
Which oral iron preparation has a lower risk of death in overdose?
carbonyl iron
What agents are used to treat iron poisoning?

moa?

Which has fewer side effects?
deferoxamin, deferasirox

iron chelators

deferasirox has fewer SE
- administer by dissoving tablet in juice or water
What are the two erythropcyte stimulating agents? Route?

moa?

indication?

SE?


epoetin alfa (IV or SC 1-3 x/week)
darbapoetin alfa (IV or SC weekly)

EPO receptor agonists, stimulate erythroid proliferation and differentiation & induce cell release from marrow

For: anemia, esp. w/ CKD, HIV, cancer, & prematurity; improve blood donation; prevent need to transfusion in surgery

HTN, thrombosis, allergic rxn, RBC aplasia (rare)
What is the difference between epoetin alfa and darbapoetin alfa?
darbapoetin is the long-acting, glycosylated form

t(1/2):

epo: 5-10 hr IV, 25 hr SC
darba: 20-25 hr IV, 50 hr SC
What are the four myeloid growth factors? Route?


filgrastin/pegfilgrastin

sargramostim

plarixafor

all are SC


filgrastin/pegfilgrastin

moa?

Indication?

SE?
G-CSF agonist on neutrophils & progenitors

neurtropenia

bone pain,
site rash

peg = one dose per chemo cycle
fil = multiple doses / day

sagramostim

moa?

Indication?

SE?
GM-CSF agonist on granulocytes, erythroid, and megakarocyte progenitors

neutropenia

fever, arthralgia (joint pain), capillary leak syndrome

- generally well tolerated, but more SE than other myeloid growth factors
plarixafor

moa?

Indication?

SE?
CXCR4 antagonist in bone marrow
→ release of stem cells

neutropenia not responsive to peg/filgrastim or argramostim

GI, site rash, fatigue,
HA, DNV
What are the three megakayocyte growth factors? Route?
oprelvekin (SC qd)

romiplostim (SC weekly)

eltrombopag (PO qd)
oprelvekin

moa?

Indication?

SE?
binds IL-11 receptors
→ stimulates platelet production

prevent thrombosis in cancer patients who had previous platelet problems during treatment

cardiac sx, fatigue, dizziness, HA
romiplostim

moa?

Indication?

SE?
TP-O agonist
→ increases platelet production

idiopathic thrombocytopenia

mild HA day of admin,
dizziness, insomnia, myalgia
eltrombopag

moa?

Indication?

SE?
TP-O agonist
→ increases platelet production

idiopathic thrombocytopenia

HA, bone marrow reticulin accumulation

BBW: hepatotoxicity
absorption decreased by food & antacids
Which megakaryocyte growth factor has a black box warning?
eltrombopag - hepatotoxicity
Which megakaryocyte's absorption is affected by food and antacids?
eltrombopag

- absorption is decreased by food and antacids
What are the two B12 supplements? Route?

Which is chemical form? Natural form?

Indications?


cyanocobalamin (SC, IM, oral less common)
- chemical def. form
hydroxocobalamin (SC, IM)
- natural form

parenteral → longer DOA

Treatment of inadequate intrinsic factor
(intrinsic factor is necessary for absorption of B12 in ileum)
What are the two folic acid supplements? Route?

moa?

Indication?
folic acid (PO, IM uncommon)
folinic acid (PO, IM uncommon)
- folinic acid is more $$$ but not more effective

F.A. is necessary for purine synthesis
(no purine → no transcription → no cell division)

Treatment of folic acid deficiency