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Pharmacology > Anemia and Hematopoietic > Flashcards

Anemia and Hematopoietic Flashcards

0
Q

Anemia caused by deficiency of Vit B12 or Folic Acid

A

Megaloblastic Anemia

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1
Q

What is the most common type of anemia?

A

Microcytic Hypochromic Anemia (Iron Deficiency)

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2
Q

What is the typical laboratory picture of IDA?

A

Low Fer, Low Ferritin, High TIBC

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3
Q

Transport protein of Iron

A

Transferrin

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4
Q

Storage protein of Iron

A

Ferritin

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5
Q

Which Iron Supplement has the highest Elemental Iron Content?

A

Ferrous Fumarate

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6
Q

Excess iron causes what reaction?

A

Fenton Reaction

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7
Q

Signs and symptoms of Acute Iron Overdose

A 
Necrotizing gastroenteritis, 
abdominal pain, 
bloody diarrhea, 
shock, 
lethargy
dyspnea
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8
Q

Effects of chronic iron overload

A

Hemochromatosis
Organ Failure
Death

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9
Q

Treatment for Acute Iron Intoxication

A

Deforxamine
Correct acid-base abnormalities
Remove unabsorbed tablets from the gut

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10
Q

What is triad of Hemochromatosis?

A

Cirrhosis
Diabetes Mellitus
Skin Pigmentation

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11
Q

Oral form of Deferoxamine?

A

Deferasirox

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12
Q

Which vitamin deficiency causes anemia and neurologic defecits?

A

Vitamin B12 deficiency

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13
Q

What are the neurologic deficits of Pernicious Anemia?

A

Ataxic Gait
Impaired position and vibratory sense
Spasticity

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14
Q

What part of the GIT is Vitamin B12 absorbed?

A

Distal Ileum

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15
Q

What is needed to absorb vitamin B12?

A

Intrinsic Factor

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16
Q

What protein transports Vit b12 in plasma?

A

Transcobalamin II

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17
Q

What are the 2 forms of Vitamin B12?

A

Cyanocobalamin

Hydroxycobalamin

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18
Q

Which is the synthetic and natural form of Vit B9?

A

Folate = Natural

Folic Acid = Synthetic

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19
Q

Vitamin B12 is essential in what 2 reactions?

A

Conversion of methylnalonyl-CoA to Succinyl CoA

Conversion of Homocysteine to Methionine

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20
Q

Folates accumulate as what metabolite?

A

N-Methyltetrahydrofolate

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21
Q

Exogenous folic acid does not correct?

A

Neurologic deficits of Vit B12 Def

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22
Q

Whatdo WBCs look like in Megaloblastic Anemia?

A

Hypersegmented Neutrophils (>5 lobes)

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23
Q

Folic acid is absorbed in what part of the GIT?

A

Proximal Jejunum

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24
Q

Enumerate the pathway of Folic Acid Synthesis

A

PABA -> (Dihydropteroate synthase) -> Dihydrofolic acid -> (Dihydrofolate reductase) -> Tetrahydrofolic Acid -> Purines -> DNA

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25
Q

What is Sargramostim or Pegfilgrastim?

A

G-CSF (Myeloid growth factor)

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26
Q

A megakaryocyte growth factor

A

Oprelvekin (IL-11)

27
Q

What is Oprelvekin used for?

A

Secondary prevention of thrombocytopenia in patients undergoing cytotoxic chemotherapy for non-myeloid cancers

28
Q

What are the 4 mechanisms of hemostasis?

A
  1. Vasoconstriction
  2. Platelet plug formation
  3. Formation of clot via blood coagulation
  4. Fibrous organization
29
Q

Factors involved in 1st step: Vasoconstriction

A

Thromboxane A2

Endothelin

30
Q

Essential for binding subendothelial collagen to platelets by Gp1b receptor in the platelet surface

A

vWF

31
Q

Factors involved in the Intrinsic Pathway or PTT

A

V, VIII, IX, X, XI, XII, Prothrombin, Fibrinogen

32
Q

Factors involved in the extrinsic pathway or PT

A

V, VII, Prothrombin, Fibrinogen

33
Q

The rate limiting factor in blood coagulation?

A

Prothrombin activator

34
Q

Aspirin is asso. with what syndrome?

A

Reye Syndrome

35
Q

What is the toxic dose of aspirin?

A

150 mg/kg

36
Q

What is the lethal dose of aspirin?

A

500 mg/kg

37
Q

What is the triad of aspirin hypersensitivity?

A

SAMTER TRIAD
Asthma
Aspirin
Nasal Polyps

38
Q

Effects of Aspirin intoxication

A

Increased respiratory drive leads to hyperventilation and respiratory alkalosis

Uncoupling of oxidative phosphorylation leads to increased anaerobic metabolism via lactic acidosis and HAGMA

39
Q

What is the expected acid-base abnormality in salicylate poisoning?

A

Respiratory Alkalosis with HAGMA

40
Q

What is the difference in presentation if aspirin intoxication in children and adults?

A

Adults: mixed acid-base disorder (Respiratory Alkalosis with HAGMA)

Children: pure acid-base disorder (HAGMA)

41
Q

Inhibits platelet aggregation by interfering with GPIIb/IIIa binding to fibrinogen and other ligands

A

Abciximab / Eptifibatide / Tirofiban

42
Q

What is the MOA of Abciximab / Eptifibatide / Tirofiban?

A

Inhibits platelet aggregation by interfering with GPIIb/IIIa binding to fibrinogen and other ligands

43
Q

What is Abciximab used for?

A

Used during PCI to prevent thrombosis

Acute Coronary syndromes

44
Q

Irreversibly inhibits binding of ADP to platelet receptors, reducing platelet aggregation

A

Clopidogrel

45
Q

What is the MOA of Clopidogrel?

A

Irreversibly inhibits binding of ADP to platelet receptors, reducing platelet aggregation

46
Q

Inhibits phosphodiesterase III and increases cAMP in platelets and blood vessels

A

Dipyridamole

47
Q

MOA of Dipyridamole?

A

Inhibits phosphodiesterase III and increases cAMP in platelets and blood vessels

48
Q

Side effects of Dipyridamole?

A

Headache because its a vasodilator, Palpitations

49
Q

What are the 2 major types of anticoagulants?

A

Indirect Thrombin Inhibitors: Heparin, Enoxaparin, LMWH

Direct Thrombin Inhibitors: Coumarin Derivatives

50
Q

Describe the structure of Heparins and Warfarins

A

Heparin: large acidic polysaccharide
Warfarin: small lipid-soluble molecule

51
Q

How is Heparin and warfarin given?

A

Heparin: parenteral
Warfarin: Oral

52
Q

Where is the site of action of Heparin vs Warfarin?

A

Heparin: blood
Warfarin: liver

53
Q

Compare the onset of heparin vs warfarin

A

Heparin: rapid (minutes)
Warfarin: slow (days)

54
Q

Compare the MOA of heparin vs warfarin

A

Heparin: activates antithrombin III
Warfarin: impairs posttranslational modification of factors II, VII, IX, X (Vit K dependent) Protein C and S

55
Q

Which is safe in pregnancy? heparin vs warfarin

A

Heparin

56
Q

What is the antidote of heparin and warfarin?

A

Heparin: Protamine
Warfarin: vitamin k, FFP

57
Q

What is the similar drug of Dipyridamole?

A

Cilostazol

58
Q

Another drug for Clopidogrel

A

Ticlopidine, Prasugel

59
Q

What is the difference between an inhibitor and an uncoupler of oxidative phosphorylation?

A

Inhibitors completely halt ETC

Uncouplers dissipate proton gradient without interrupting the ETC

60
Q

Give 8 examples of CYP450 Inducers

A 
Ethel Booba takes Phen-Phen and reduces greasy carb shakes
ETHANOL
BARBITURATES
PHENYTOIN
RIFAMPICIN
GRISEOFULVIN
CARBAMAZEPINE
ST JOHN's WORTH
SMOKING
61
Q

Give 9 examples of CYP450 inhibitors

A 
Inhibitors stop cyber kids from Eating GRApefruit Q
ISONIAZID
SULFONAMIDES
CIMETIDINE
KETOCONAZOL
ERYTHROMYCIN
GRAPEFRUIT JUICE
RITONAVIR
AMIODARONE
QUINIDINE
62
Q

Warfarin inhibits what enzyme?

A

Epoxide reductase

63
Q

Which anticoagulant does not require aPTT monitoring?

A

Enoxaparin, Fondaparinux

64
Q

Which has a narrow therapeutic window, Heparin or Warfarin?

A

Warfarin

65
Q

What is the antidote for Lepirudin?

A

No reversal agent exists

Pharmacology (6 decks)

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