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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 |
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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 |
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Which oral iron preparations are 12-33% elemental iron?
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Ferrous sulfate (20-30%)
Ferrous gluconate (12%) Ferrous fumarate (33%) |
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Which oral iron preparations are 100% elemental iron?
---> expensive! |
polysaccharide iron complex
carbonyl iron |
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What is the value of sustained release iron formulations?
|
pretty much nothing
they may have fewer SE, but probably only because of lower absorption |
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Which parenteral iron preparation uses a preservative?
|
sodium ferric gluconate
|
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What are the four parenteral iron preparations?
|
ferumoxytol
sodium ferric gluconate iron dextran iron sucrose |
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Which parenteral iron formulation is suitable for patients with CKD?
|
ferumoxytol
|
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Which parenteral iron formulation is suitable for patients taking erythropoietin therapy?
|
sodium ferric gluconate
|
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Which parenteral iron formulation is suitable for patients taking epoetin alfa therapy?
|
iron sucrose
|
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Which parenteral iron preparations has a black box warnings?
|
iron dextran,
iron sucrose - anaphylaxis |
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Which parenteral iron is available in IM formulation?
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iron dextran
|
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What are the common SE of ferumoxytol?
|
diarrhea, constipation,
nausea, dizziness, hypotension, peripheral edema |
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What are the common SE of sodium ferric gluconate?
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cramps, N&V,
flushing, rash, hypotension, pruritis (itchy skin) |
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What are the common SE of iron dextran?
|
pain/browning at site,
flushing, fever, chills, hypotension, myalgia, anaphylaxis |
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What are the common SE of iron sucrose?
|
leg cramps,
hypotension |
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Which oral iron preparation has a lower risk of death in overdose?
|
carbonyl iron
|
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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 |
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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) |
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What is the difference between epoetin alfa and darbapoetin alfa?
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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 |
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What are the four myeloid growth factors? Route?
|
filgrastin/pegfilgrastin
sargramostim plarixafor all are SC |
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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 |
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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 |
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What are the three megakayocyte growth factors? Route?
|
oprelvekin (SC qd)
romiplostim (SC weekly) eltrombopag (PO qd) |
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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 |
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romiplostim
moa? Indication? SE? |
TP-O agonist
→ increases platelet production idiopathic thrombocytopenia mild HA day of admin, dizziness, insomnia, myalgia |
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eltrombopag
moa? Indication? SE? |
TP-O agonist
→ increases platelet production idiopathic thrombocytopenia HA, bone marrow reticulin accumulation BBW: hepatotoxicity absorption decreased by food & antacids |
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Which megakaryocyte growth factor has a black box warning?
|
eltrombopag - hepatotoxicity
|
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Which megakaryocyte's absorption is affected by food and antacids?
|
eltrombopag
- absorption is decreased by food and antacids |
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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) |
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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 |