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45 Cards in this Set
- Front
- Back
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what are the 3 causes of anemia?
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-impaired red blood cell production
-impaired Hbg synthesis -decrease in RBC survival |
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what are some s/s of anemia
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weakness
fatigue vertigo tachy |
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b-12 deficiency and folate deficiency are indicitive of what type of anemia?
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macrocytic
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iron deficiency is indicitive of what type of anemia?
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microcytic
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what lab is a reflction of total iron stores?
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serum ferritin
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at what level of %TSAT should you begin iron therapy?
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TSAT < 20% or Ferritin <100
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what patient would receive a bone marrow biopsy?
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normalcytic anemia
+ low reticulocyte count + unknow cause to r/o myelodysplasia |
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what do reticulocytes represent?
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immature RBC's
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what are some etiologies of microcytic anemia?
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iron deficiency
chronic diseases thallassemia sickle cell HIV |
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what are some lab findings in a patient with microcytic anemia?
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decreased serum IRON, transferrin, ferritin
INCREASED TIBC |
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what are some etiologies for normalcytic anemia?
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acute blood loss
hemolytic anemia chronic disease |
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what are some causes of macrocytic anemia?
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b12 or folic acid def.
AZT pernicious anemia folate def: alcoholics |
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what are growth factors indicated for?
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anemia, crf, azt-related anemia, chemo induced anemia
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what are the adverse effects for growth factors?
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severe HTN, tachycardia
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what is the MOA of growth factors?
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binds to receptor on surface of erythroid precursor cells in bone marrow which leads to erythropoiesis
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what are two examples of growth factors?
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erythropoietin or darbopoetin
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if hbg is below 11.7 what treatment is needed?
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erythropoeitin
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what is the iron therapy of choice?
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ferrous sulfate
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what is the numerical value of the ANC that you should stop nupogen therapy?
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if ANC is > 1500 for two consecutive days
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when is erythropoietin indicated?
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microcytic anemias:
CRF any Hbg <11.7 |
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glycoproteins that stimulate the proliferation and diff of one or more myeloid cell lines
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myeloid growth factors/ GM-CSF
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what two types of wbc are needed for calculating the ANC?
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segs
bands |
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what is the MOA of sargramostim?
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stimulates myelopoesis: for p with pancytopenia
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when is sargramostim or nupogen indicated?
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hiv associated neutropenia (AZT)
p undergoing surgery, bone marrow, transplant p |
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what is the MC used G-CSF that stimulates myeloid cells?
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NUPOGEN
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what is the dose for nupogen?
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5mcg/kg/day
sub cutaneous inj |
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what is the equation for calculating the ANC?
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ANC= (B + S ) x WBC
answer x 100 |
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what is the long acting form of nupogen?
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neulasta
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what are the unique and severe adverse effects of the GM-CSF therapies?
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(nupogen, neulasta etc...)
severe bone pain malaise flu-like symptoms |
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what state must iron be in in order to be absorbed?
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ferrous:having a + charge
ferrous sulfate ferrous glutanate 324 mg PO TID |
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what is the best ca supplement to be on?
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calcium carbonate: the highest percentage of ca+ available to be absorbed
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what are the clinical indications for iron therapy?
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malabsorption, chronic blood loss, repeated pregnancy, inadequate dietary intake
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which forms of iron have the most elemental iron available for absorption?
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ferrous fumerate
ferrous sulfate |
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what is a major side effect of taking iron supplement?
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constipation
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what is the MC iron supplement?
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ferrous sulfate = feosol
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p has chronic constipation due to opiote regimen what iron supplement would you put them on?
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ferrous gluconate
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what is the indication for IV Iron?
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p on dialysis
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if p is NPO and they need iron , what can we do?
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give IV iron even though it is not FDA approved.
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p is on erythropoietin or darbopoeitin what combo regimen of iron supplement would work the best/quickest to get their H/H back up to normal values?
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ferrous sulfate= feosol
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what is the disadvantage to IV iron?
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since it is bypassing the absorbtion through the jejunum, it will only supplement temporarily
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what are the TWO forms of IV iron?
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venofur
ferllicit |
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What is the protocol for giving IV ferllicit?
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must give test bolus dose of 25mg over one hour.
if no reaction then give: 125mg IV TIWeek |
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which type of iron causes the highest rate of anaphylactic reaction?
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iron dextran
subC/IM try to give IV ferllicit |
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what is the tx for iron toxicity?
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defaroxamine
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chronic iron overdose = hemochromatosis therapy is?
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phlebotomy
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