Drugs Acting On The Blood

Question 0

Epoetin alfa indications

Answer 0

Anemia of chronic renal failure; in AIDS patient
cancer related (epo should be <100u/l)
Surgery
Premature
Zidovudine treatment

Question 1

Most important regulator of the proliferation of committed progenitors and their immediate progeny

Answer 1

Erythropoetin

Question 2

Epoetin alfa monitoring

Answer 2

Hiv & cancer patients: Hct 1x/week
Renal failure: 2x/week
Decrease dose if Hct inc >4pts

Question 3

Epoetin alfa AE

Answer 3

Absolute or fxnal iron deficiency
Thromboembolic events
Cardio:inc bp, hypertensive encephalopathy, seizures

Question 4

Myeloid growth factors

Answer 4

Gcsf gmcsf
By fibroblasts, endothelial cells, macrophages, T-cells
Gcsf used more since less toxic

Question 5

Gm csf

Answer 5

Myelopoeisis,shorten neutropenia
Sq or iv, leukocyte count return to baseline 2-10 days
Low-neutrophilic, high-monocytosis and eosinophilia
Capillary leak syndrome with prolonged admin

Question 6

G csf

Answer 6

Inc neutrophil by stimulating cfu g
Reduce episodes of febrile neutropenia
Ae produces marked granulocytosid and splenomegaly

Question 7

Interleukin 11

Answer 7

For under chemo for nonmyeloid malignancies
Intestinal epithelial cell growth, osteoclastogenesis, inhibit adipogenesis
Ae:may require diuretics; blurred vision

Question 8

Thrombopoetin

Answer 8

Recombinant human megakaryocyte growth and devt factor
PRIMARY regulator of platelet production
Produced by liver, marrow, stromal cells

Question 9

Most common nutri disorder

Answer 9

Iron deficiency

Question 10

Largest amt of dietary iron ingested by underprivileged

Answer 10

Nonheme iron

Question 11

New erythrocytes

Answer 11

catabolized by RES

Question 12

Sites of iron storage

Answer 12

Res, spleen, bone, intestinal mucosa cells, hepatocytes

Question 13

Acts as natural ceiling and regulates absorption of iron

Answer 13

Small intestine

Question 14

INDICATION of effectiveness of iron therapy

Answer 14

Inc reticulocyte count 4-7 days after

Inc hb/hct 3-4 weeks after treatment

Question 15

Iron absorption is decreased by

Answer 15

Food and antacids

Question 16

Oral iron ae

Answer 16

Nausea and abs pain
Constipation >diarrhea
TEMP staining of teeth
WOF hemochromatosis

Question 17

Treatment for od of oral iron

Answer 17

Induce vomiting
Colortest
Deferoxamine
Activated charcoal cant be used for iron poisoning

Question 18

Parenteral iron

Answer 18

Iron malabsorption
Intolerance of metal iron
Create iron stores in pregnant women

Question 19

Ferritin levels=?

Answer 19

Total iron binding capacity

Question 20

Warning for parenteral iron

Answer 20

Can cause anaphylaxis, usewhen indicated

Question 21

Preparation for parenteral irons

Answer 21

Ferric gluconate complex
Iron sucrose
Iron dextran- iv route, use z track when IM(buttocks)

Question 22

Copper deficiency

Answer 22

Leukopenia(granulocytopenia, anemia)
Menke’s disease
Treatment-cupric sulfate

Question 23

Pyridoxine

Answer 23

For sideroblastic anemia
Isoniazid and pyrazinamide
Levodopa
Chloramphenicol

Question 24

Vit b12

Answer 24

If inadequate, becomes trapped as methyltetrahydrofolate

Question 25

Methylcobalamin

Answer 25

Homocysteine to methionine

Question 26

5deoxyadenosylcobalamin

Answer 26

Isomerization of LmethylmalonylCoa to succinylcoa

Question 27

Vitb12 deficiency

Answer 27

``` Pt with gastric atrophy, surgery, antibodies top arietal cells Assoc with neurologic abnormalities Megaloblastic erythropoiesis Pancytopenia Schilling test ```

Question 28

Requirements for ileal transport of vit b12 include

Answer 28

Intrinsic factor Bile Sodium bicarbonate

Question 29

Folic acid metabolic functions

Answer 29

``` Homocysteine to methionine Serine to glycine Thymidylate Histidine metabolism Purines ```

Question 30

Daily requirements of folic acid

Answer 30

Green vegetables, liver, yeast, some fruits

Question 31

Folate deficiency

Answer 31

By diseases of the small intestine MOST COMMON cause of folate deficienct megaloblastic erythropoiesis Lead to megaloblastic anemia

Question 32

Drugs that inhibit dihydrofolate reductase

Answer 32

MTX | TMP

Question 33

Drugs that interfere with absorption and storage of folate

Answer 33

Some AEDs and OCP

Question 34

folic acid therapy

Answer 34

Do not treat patients with vit b12 deficiency with folic acid Absorption requires transport and action of pteroglutamyl carboxypeptidase associated with mucosal cell membranes

Question 35

Folate is stored within cells as

Answer 35

Polyglutamates

Question 36

A better measure of folate levels than serum folate

Answer 36

RBC folate