Drugs For Blood Formation Flashcards
Mucosal block theory
The gut has a mechanism to prevent entry of excess iron in the body. Iron reaching inside mucosal cell is either transported to plasma or oxidised to ferrie form and complexed with apoferritin to form ferritin. This ferritin generally remains stored in the mucosal cells and is lost when they are shed (lifespan 2-4 days). This is called the ‘Ferritin curtain’.
Iron levels are regulated as such
Which oral iron is preferred and why
Dissociable ferrous salts are preferred over ferric salts because of high iron content and more absorption
Oral preparations of iron examples
Ferrous sulphate
Ferrous gluconate
Carbonyl iron
Ferrous fumarate
Colloidal ferric hydroxide
Iron calcium complex
Ferrous ammonium citrate
Most important side effect of oral iron
Gastric irritation and constipation
ADR of oral iron
Side effects related to elemental iron content
Epigastric pain, heartburn, nausea, vomiting, bloating, metallic taste, staining of teeth
Constipation
Calculate parenteral iron
4.4 x body weight x hb deficit per day
Parenteral iron preparations
Iron dextran
Ferrous sucrose
Ferrous carboxymaltose
Iron isomaltoside
Uses of iron therapy
Iron deficiency anemia :treatment and prophylaxis
Megaloblastic anemia: masking
Iron chelating agent given for iron toxicity
Desferrioxamine
Actions of EPO when stimulated by anemia or hypoxia
Increases CFU-E
Increases hb synthesis
Increases maturation of rbc
Release of reticulocytes
Two examples of EPO
Epoetin alpha beta
Darbepoetin alpha
Uses of EPO
- Anemia in CKD
- Anemia in aids to patient treated with zidovudine
- Anemia in cancer therapy
- Preoperative increased blood production l
ADR of EPO due to
Increase in hematocrit
Increase in viscosity
Increase in P.V.R
ADR of EPO
Increased clot formation in A-V shunts
Hypertensive episodes or raised bp
Thromboembolic events
Seizures
Darbopoetin advantage over epoetin
Longer acting
