Pharm Final - Hematopoetic Drugs

Front 1

name 4 iron supplements

Back 1

1) Ferrous Sulfate
2) Ferrous Gluconate
3) Ferrous Fumarate
4) Iron Dextran

Front 2

name 2 inactive forms of Vit B12

Back 2

1) Cyanocobalamin
2) Hydroxycobalamin

Front 3

Name 1 iron chelator

Back 3

1) Deferoxamine

Front 4

Name 2 active forms of Vit B12

Back 4

1) Deoxyadenosylcobalamin
2) methylcobalamin

Front 5

_________inhibits folate reductase

Back 5

methotrexate

Front 6

name 2 hematopoetic growth factors that are recombinant human EPO

Back 6

1) Epoetin
2) Barbepoetin

Front 7

name 3 colony stimulating growth factors

Back 7

1) Filgrastim (RHuG-CSF)
2) Sargamostim (RHuGM-CSF)
3) Pegfilgrastim

Front 8

Cardiovascular adaptation to chronic anemia

Back 8

1) tachacardia
2) increased Cardiac Output
3) Vasodilation

Front 9

Iron is needed for_______

Back 9

Hb synthesis

Front 10

B12 is needed for ____________

Back 10

DNA synthesis

Front 11

Folic Acid is needed for__________

Back 11

the synthesis of pyrimidine and purine bases and amino acids

Front 12

Trace the cycle of ingested iron

Back 12

1) ingested iron is absorbed from the intestinal mucosa into the circulation, where it is bound to transferrin
2) Iron is distributed to tissue for incorporation into Hb, Myoglobin, and enzymes, or it is stored as ferritin
3) after 120 days, erythrocytes are degraded by reticuloendothelial cells, and the iron is retained in the plasma or stored

Front 13

Iron is absorbed in the ______state

Back 13

absorbed in the reduced state (+2)

AKA ferrous

Front 14

Iron is stored in the ______state

Back 14

stored in the oxidized state (+3)

AKA ferric

Front 15

Given the recycling of Iron and dieary abbundane of Fe, intake is not typically a major concern....It is a concern in these 6 circumstances__________

Back 15

1) Children
2) pregnancy
3) menstruation
4) female athletes
5) surgery
6) disease

Front 16

where is iron absorbed?

Back 16

1) duodenum and proximal jejunum

Front 17

greatest source of Iron________(bioavalability)

Back 17

Meat >>>>>plants

Front 18

what does transferrin do for iron?

Back 18

1)transport -- Rc mediated entry into RBC

Front 19

how is iron eliminated?

Back 19

1) no mechanism per se
2) mucosal cells in stool, trace amount in urine, bile, and sweat
3)***regulated at the level of absorption and storage

Front 20

causes of microcytic anemia?

Back 20

1) iron deficiency
2) thalasemia
3) lead toxicity

Front 21

treatment for iron deficiency (oral)

Back 21

1) ferrous sulfate
2) ferrous gluconate
3) ferrous fumarate

Front 22

treatment for iron deficiency (IM or IV)

Back 22

Iron dextran (ferric hydroxide + dextran)

Front 23

what affects the absorption of the oral preparations of iron?

Back 23

1) food decreases absorption
2) Vit C increases absorption

Front 24

treat Acute Iron toxicity

Back 24

1) acute iron toxicity typically occurs in children (10 oral tablets can be lethal)
----whole bowell irrigation
----Deferoxamine

Front 25

what is deferoxamine

Back 25

1) iron chelator used in acute iron toxicity

Front 26

what causes chronic iron toxicity?

Back 26

1) genetics
----hemochromatosis
2) acquired
----many RBC transfuscions

Front 27

you can get inactive forms of Vit B12 from what food products?

Back 27

1) meat
2) dairy

Front 28

what does the active form of Vit B12 "deoxyadenyslcobalamin" do?

Back 28

1) aids in the conversion of methylmalonyl-CoA --> Succinyl CoA
2) Succinyl CoA is used fir a.a. and FA catabolism

Front 29

what does the active form of Vit B12 "methylcobalamin" do?

Back 29

1) provides the methyl group for the conversion of homocystine --> methionine
------in this process methylcobalamin is converted to cobalamin

2) cobalamin is converted back to methylcobalamin cia methyl-H4-folate
--this converts methyl-H4 folate -->H4 folate
----------------H4 folate donates single carbons to pyrimidines and purines and aa

Front 30

what function does glucoprtein play with B12

Back 30

1) glucoprotein is a intrinsic factor secreted by parietal cells of the gastric mucosa
---it facilitates absorption of Vit B12

Front 31

deficiency of Vit B12 --> the accumulation of ____________

Back 31

1) methylmalonyl CoA (goes to methylmalonic acid)
2) homocystine

Front 32

if Vit B12 deficient what is the ROA

Back 32

most B12 deficiencies are due to malabsorption, thus parenteral injections are required
----IM daily for 1-2 weeks then 1/month for life

Front 33

which of the B12 supplements are prefered

Back 33

1) hydroxycobalamin
----b/c it remains longer in circulation (highly bound to plasma proteins)

Front 34

where is folic acid absorbed at?

Back 34

proximal jejunum

Front 35

_________may--> folate deficiency

Back 35

1) inadequate dietary intake of:
-----organ meats
-----beans
-----green veggies
2) Alcoholics (or other liver diseases)
3) ***poor diet, reduced absorption, increased metabolism, or decreased storage

Front 36

folic acid is an enzymatic cofactor for________________

Back 36

1) DNA synthesis
2) B12 dependant methionine production
3) purine, pyrimidine, and aa synthesis

Front 37

name 1 drug that decreases folate absorption / metabolism

Back 37

1) methotrexate (Folate reductase)

Front 38

thalasemia is prevalant in the __________population

Back 38

prevalant in the mediterranean population

Front 39

characteristics of sideroblastic anemia

Back 39

1) iron levels are normal but not incorporated into Hb
2) Fe accumulates in the mitochondria

Front 40

causes of B12 DEFICIENCY

Back 40

1) PERNICIOUS ANEMIA
2) vegans
3) alcoholics
4) celiac disease

Front 41

causes of Folate deficiency

Back 41

1) pregnancy
2) phenytoin
3) malignancy

Front 42

causes of normocytic anemia

Back 42

1) Uremia
2) Malignancy
3) RA
4) Aplastic anemia

Front 43

EPO is a __________
--its function is_____

Back 43

1) glycoprotein
2) hematopoetic growth factor (stimulate RBC production)

Front 44

where is EPO produced? what is its stimulus?

Back 44

1) kidneys
2) in response to hypoxia

Front 45

how does EPO stimulate RBC

Back 45

EPO binds on Rc on RBC progenator --> stimulates proliferation / differentiation
----induces release of reticulocytes from the bone marrow

Front 46

EPO typicslly has an inverse relationship with Hb andHct...when is this not true?

Back 46

1) renal disease: (b/c kidney produces EPO) so even if you have anemia the kidney cant keep up with demand

Front 47

EPO may need to be given when_____________b/c EPO decreases the need for blood transfusions

Back 47

1) cancer chemotherapy
2) HIV therapy
3) Chronic renal failure

Front 48

if you have an EPO deficiency then you can give ____________

Back 48

1) Epoetin
2) Darbepoetin (3x longer half life due to sialic acid content)

Front 49

when you give EPO also give____________

Back 49

iron & folate
--------to mantain stores

Front 50

G-CSF stands for

Back 50

granulocyte colony stimulating factor

Front 51

GM-CSF stands for

Back 51

granulocyte macrophage colony stimulating factor

Front 52

what is the fx of the drugs that have G-CSF and GM-CSF capability?

Back 52

1) they are myeloid growth factors
2) they bind to the Rc on various myloid progenators --> stimulate proliferation / dfferentiation
3) stimulates mature Neutrophils
---stimulates phagocytic activity
----prolongs cell survival in circulation
*****they are colony stimulating factors used in the tx of neutropenia associated with cancer chemtherapy, and bone marrow transplant

Front 53

which drug has G-CSF capability

Back 53

filgrastim

Front 54

which drug has GM-CSF capability?

Back 54

sargramostim

Front 55

what is uniwue about pegfilgrastim?

Back 55

1) covalent conjugation product of filgastrim and polyethylene glycol that has a much longer half life (42 hours)
2) modification increases the size of the molecule such that it is to large for renal clearabce

Front 56

how is pegfilgrastim eliminated?

Back 56

primarily by neutrophil uptake and metabolism

Front 57

these 2 forms of B12 are cofactors for methylation reactions?

Back 57

1) deoxyadenosylcobalamin
2) methylcobalamin

Front 58

folate is needed for purine base synthesis. if methotrexate is given it will inhibit the synthesis of____________

Back 58

1) DNA
2) RNA
3) THYMIDYLATES
4) Proteins