Agents used in anemia Flashcards
Iron preparations used for IDA
Ferrous sulfate
Ferrous fumarate
Ferrous gluconate
Fe-Hydroxide-polymaltose
What is the kinetics of iron replacement treatment?
Slow, long treatment over 2-6 months
Adverse effects of oral iron preparates
Mild, GI upset, nausea
constipation
What are the parenteral preparations of iron?
How is it given
They are only FERRIC, he’s parenteral
Iron dextran
Iron sucrose
Sodium-ferric-gluconate complex
Given i.v. in a slow infusion
Adverse effects of parenteral iron
Potential for anaphylactic shock
What is the form of vitamin B12 used in replacement therapy?
What is the active form?
How is it administered?
Hydroxycobalamin or cyanocobalamine
Methylcobalamin
Since most B12 deficiencies are caused by a failure of absorption (pernicious anemia, illeal resections),
It should be administered parenterally,
There are no toxicities.
Folate replacement
Done orally, no significant toxicity
Drugs for stimulating RBCs
SEs
epoeitin alpha
darbepoetin alpha
methyl-PEG-epoetin beta
SEs:
hypertension
thrombosis
Drugs for stimulating neutrophils
Filgrastim and Sargramastin
Filgrastim = G-CSF
Sargramostim = GM-CSF
Sargramostin function
GM-CSF, stimulates neutrophil and other myeloid cells proliferation, including other PMNs and Megakaryocytes, platelets.
It also mobilizes hemapoeitic stem cells to a degree
Used to increase recovery of WBCs after chemotherapy of marrow transplants.
What adjunct increases the effectiv eness of Filgrastim?
Plerixafor
inhibits CXCR4, increasing the mobilization of blood stem cells in prep for an autologous stem cell transplant.
What drugs stimulate megakaryocyte growth
Oprelvekin - IL-11 analog
Romiplostim
Eltrombopag
Oprelvekin
IL-11
stimulates megakaryocytes, increasing platelet counts.
Used after chemo.
SEs:
headache, fatigue, dizziness
fluid retention
Romiplostim
Thrombopoietin receptor agonist, with a unique peptide structure
Given subcutaneously for patients with refractory idiopathic thrombocytopenia
Eltrombopag
Thrombopoietin receptor agonist for refractory idiopathic thrombocytopenia,
given orally.
