Anemia Pharm

Question 1

2 classes for Anemia treatment

Answer 1

erythropoiesis stimulating agents

vitamins and minerals

Question 2

erythropoiesis stimulating agent prototype drug

Answer 2

epoetin alfa (Epogen, Procrit)

Question 3

MOA of epoetin alfa (Epogen, Procrit)

Answer 3

Mimics human erythropoietin

Question 4

epoetin alfa is FDA-approved to maintain RBC counts in patients with:

Answer 4

Chronic kidney failure

HIV infection on drug therapy

Anemia 2° chemotherapy in certain cancers

Pre-operative in patients with anemia

Question 5

route of epoetin alfa

Answer 5

sub-Q

Question 6

What needs to be weighed with epoetin alfa

Answer 6

RISKS vs BENEFITS

Question 7

What is increased in chronic kidney disease with epoetin alfa

Answer 7

Increased mortality and serious cardiovascular events

Question 8

What is increased in cancer with epoetin alfa

Answer 8

Increased mortality and tumor progression

Question 9

what is increased in surgery patients with epoetin alfa

Answer 9

Increased thromboembolic events and mortality

Question 10

When do we not initiate epoetin alfa therapy

Answer 10

Hgb >= 10

Question 11

dosing of epoetin alfa

Answer 11

lowest dose possible to reduce the need for transfusion

Question 12

2 nursing implications for epoetin alfa

Answer 12

Monitor BP before and during therapy

Monitor Hgb levels

Question 13

Where is Dietary Iron found

Answer 13

collard greens
choy
tomatoes
green beans
brussel sprouts
broccoli
kale 
spinach

Question 14

2 forms of dietary iron

Answer 14

heme

non heme

Question 15

heme iron

Answer 15

40 percent of the iron in meat, poultry, and fish

Well absorbed

Question 16

non heme iron

Answer 16

Non-heme iron
60 percent of iron in animal tissue

All the iron in plants (fruits, vegetables, grains, nuts)

Less well absorbed

Question 17

Iron therapy prototype drug

Answer 17

Ferrous Sulfate

Question 18

indications for ferrous sulfate

Answer 18

Iron deficiency / Prevention

Question 19

MOA for Ferrous Sulfate

Answer 19

Taken up by bone marrow cells to make hemoglobin

Question 20

A/E of Ferrous Sulfate

Answer 20

GI disturbances
Teeth staining
Tarry Stools

Question 21

dosage issues for iron therapy

Answer 21

Ferrous sulfate only contains 20% elemental iron by weight

Elemental iron - available for absorption

Question 22

Interactions for Iron Therapy

Answer 22

Antacids reduce absorption

Food helps prevent GI side effects

Food decreases absorption by 50-70%

Question 23

Toxicity of Iron Therapy

Answer 23

Risk of overdose

Stomach pain, N & V, diarrhea

Question 24

Parenteral Iron (IM/IV) prototype drug

Answer 24

Iron Dextran (DexFerrum)

Question 25

Indication of Iron Dextran

Answer 25

Clear diagnosis of iron deficiency

Oral iron is intolerable or ineffective

Question 26

black box warning of Iron Dextran

Answer 26

potentially fatal anaphylaxis

Question 27

Safety implications of Iron Dextran

Answer 27

Only use when absolutely necessary

Epinephrine and CPR equipment

Small “test” dose before each full dose

Question 28

Disadvantages of Iron Dextran (IM)

Answer 28

Persistent pain
Discoloration
Tumors
Risk of anaphylaxis

Question 29

Vitamin B12 prototype

Answer 29

Cyanocobalamin

Question 30

Indication for B12 therapy

Answer 30

B12 deficiency

Question 31

route of Vitamin B12

Answer 31

Oral

Question 32

Adverse effects of vitamin b12

Answer 32

hypokalemia

Question 33

MOA of folic Acid

Answer 33

Converts to the active form of folic acid after administration

Question 34

Indications of Folic Acid

Answer 34

Treatment of folic acid deficiency anemia
Prophylaxis of folate deficiency
Initial treatment of severe anemia from vitamin B12 deficiency

Question 35

Adverse effects of folic acid

Answer 35

none

Question 36

Folic acid can do what to b12

Answer 36

mask deficiency

Question 37

vitamins and minerals for anemia

Answer 37

Iron (ferrous sulfate)
Vitamin B12
Folic acid