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Pharmacology > Drugs for anemia chapter 49 > Flashcards

Drugs for anemia chapter 49 Flashcards

1
Q

Describe rbc normally and in anemia ?

A

RBCs:
* carry oxygen to tissues
* remove carbon dioxide
(transport to lungs to exhale)
* Disorder with too few or
ineffective RBCs
* Results from alteration in
erythropoiesis

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2
Q

What can help produce healthy rbc ?

A

Adequate amounts of iron
* To form hemoglobin rings

Minute amounts of vitamin B12 and folic acid
* To form supporting structure

Essential amino acids and carbohydrates
* To complete the hemoglobin rings, cell membrane, and basic structure

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3
Q

What are different types of anemia ?

A
  • Iron Deficiency Anemia

Megaloblastic Anemias
* Insufficient folic acid or vitamin B12 to create the stromal structure needed in a healthy RBC

Pernicious Anemia
* gastric mucosa cannot produce intrinsic factor  needed for B12 absorption

Folate deficiency
* Folate – essential for cell division in all types of tissues

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4
Q

What is Erythropoietin – glycoprotein

A
  • Released from kidney in response to:
  • Decreased blood flow
  • Decreased oxygen in kidneys
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5
Q

What is epoetin alfa (Epogen)

A

Erythropoiesis-stimulating agent

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6
Q

What are therapeutic actions of epoetin alfa (Epogen)?

A

Erythropoiesis-stimulating agent

  • Stimulates production of RBCs
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7
Q

What are indications of epoetin alfa (Epogen)?

A

Erythropoiesis-stimulating agent

  • Anemias associated with renal failure and AIDS; decreases need for blood transfusions in patients undergoing surgery
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8
Q

What are pharmacokinetics of epoetin alfa (Epogen)?

A

Erythropoiesis-stimulating agent

  • IV or SC
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9
Q

What are adverse effects of epoetin alfa (Epogen)?

A

Erythropoiesis-stimulating agent

  • CNS effects – HA, arthralgia, fatigue
  • CV effects –> r/t increase in RBC, balance within CV system
    htn,edema, chest pain
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10
Q

What are contras of epoetin alfa (Epogen)?

A

Erythropoiesis-stimulating agent

  • Uncontrolled hypertension( pressure in vascular system increases when rbc increase so it can worsen htn)
  • Allergy to human albumin
  • Lactation
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11
Q

What are cautions of epoetin alfa (Epogen)?

A

Erythropoiesis-stimulating agent

  • Follow Hgb and HCT
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12
Q

Who is at risk for iron deficiency ?

A
  • Menstruating women who lose RBCs monthly
  • Pregnant and nursing women
  • Rapidly growing adolescents
  • Persons with GI bleeding
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13
Q

What is ferrous sulfate (Feosol)?

A

Agents for iron deficiency anemia

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14
Q

What are therapeutic actions of ferrous sulfate (Feosol)?

A

Agents for iron deficiency anemia
* Elevate serum iron concentrations

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15
Q

What are indications of ferrous sulfate (Feosol)?

A

Agents for iron deficiency anemia

  • May also be used as adjunctive therapy in
    patients receiving epoetin alfa
  • Pregnancy/ lactation -> meet increased demands of iron
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16
Q

What are pharmacokinetics of ferrous sulfate (Feosol)?

A

Agents for iron deficiency anemia

  • Absorbed in the small intestines
  • Can take 2-3 weeks to see improvement
  • Oral form preferred

to reduce the risk of subcutaneous staining and irritation

17
Q

What are adverse effects of ferrous sulfate (Feosol)?

A

Agents for iron deficiency anemia

GI effects  N/V, dark stools, constipation
* CNS
* Parenteral  associated with anaphylaxis
reactions
* Consider Z track for IM injections
* Liquid stains teeth

18
Q

What are contras of ferrous sulfate (Feosol)?

A

Agents for iron deficiency anemia
* Allergies
* Hemochromatosis(excessive iron) & hemolytic anemia( anemias that aren’t iron anemia)
* Peptic ulcer, colitis( could cause exacerbation)

19
Q

What are drug interactions ferrous sulfate (Feosol)?

A

Agents for iron deficiency anemia
-Iron absorption decreases if iron preparations are taken with antacids, substances with calcium and magnesium
-Iron is not absorbed well if taken with antacids, eggs, milk, other calcium-containing substances, coffee, or tea. These substances should not be administered concurrently. Vitamin C may enhance the absorption of iron but also may increase the GI side effects.

20
Q

Describe chelating agents

A
  • Heavy metal buildup/ toxicity
  • Iron, lead, arsenic, mercury, copper, gold
  • Chelating agents – drugs that counteract metal toxicity
  • hold metal so it can be transported out of the body before it harms tissue
21
Q

What is deferoxamine mesylate (Desferal)

A

Chelating agent

22
Q

What are indications of deferoxamine mesylate (Desferal)?

A

Chelating agent

Indicated for high levels of iron

23
Q

What are contras/cautions of deferoxamine mesylate (Desferal)?

A

Chelating agent

Vision changes, rash, pain at injection site

24
Q

What is MEGALOBLASTIC ANEMIAS?

A

Folate Deficiencies
* Secondary to increased demand
* Absorption problems
* Drugs that cause folate deficiencies
* Secondary to the malnutrition of alcoholism

Vitamin B12 Deficiencies
* Poor diet or increased demand
* Lack of intrinsic factor in the stomach

25
Q

Folic acid and B12 are usually given together. What are therapeutic actions?

A

Megaloblastic anemia
* Essential for cell growth and division
* Production of a strong supportive structure in RBCs
* B12 is also necessary for the maintenance of myelin sheath

26
Q

Folic acid and B12 are usually given together. What are the indications?

A

Megaloblastic anemia
* Dietary deficiencies, pregnancy
* Folic acid used as rescue drug for cells exposed to some toxic chemotherapeutic agents
FOLIC ACID AND VIT B12

27
Q

What are indications of folic acid?

A

Folic acid deficiency
* Given during pregnancy to prevent
neural tube defects

28
Q

What are pharmacokinetics of folic acid?

A

Folic acid deficiency

Available PO, IM, IV and SQ

29
Q

What are adverse affects of folic acid?

A
  • Monitor for pain at injection site
  • Mild diarrhea
30
Q

What are contras of folic acid?

A

allergy

31
Q

What to be caution of with folic acid?

A

Dose appropriateness

32
Q

What is hydroxocobalamin?

A

Vitamin b12 replacement

33
Q

What are pharmacokinetics of hydroxocobalamin?

A

Vitamin b12 deficiency
* Given IM; unable to be absorbed PO
* Given for 5-10 days to reach blood level then monthly for life

34
Q

What are adverse affects of hydroxocobalamin?

A

vitamin b12 replacement
Rash, itching, diarrhea, allergic reaction

35
Q

What are contras of hydroxocobalamin?

A

allergy

36
Q

LIFESPAN CONSIDERATIONS:
DRUGS USED TO TREAT ANEMIAS
children

A
  • Proper nutrition
  • epoetin alfa –> safety not
    clearly established
  • Dosing determined by age
  • Use straw to prevent teeth
    staining with iron
37
Q

LIFESPAN CONSIDERATIONS:
DRUGS USED TO TREAT ANEMIAS
adults

A
  • Assess proper nutrition
  • Monitor effect with blood tests
  • Monitor for GI effects

Pharmacology (39 decks)

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