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45 Cards in this Set

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