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Flashcards in Drugs To Know Deck (13):


Used to treat actuely low THF levels; often due to drug therapies
o Methotrexate – inhibits DHFR so folate can’t be turned into its active form (THF)
o Trimethoprim – antimicrobial that inhibits DHFR in bacteria and humans
o Pyrimethamine – antimalarial that inhibits DHFR in falciparum malaria and humans
o Phenytoin – antiepileptic that inhibits folate uptake
o Treat with leucorvorin (doesn’t need DHFR to be active)


Folic Acid Supplementation

o Alcoholics/Liver disease – impairs absorption and diminishes folate storage proteins in liver
o Pregnant women – need more folate because they’re making a baby. Best to supplement to decrease incidence of neural tube defects
o Malabsorbtion - problems with absorbtion in the jejunum will impair folate the most
o Renal dialysis – removes folate from the blood



- Used to treat B12 deficiency
- longer lasting formulation



- Used to treat B12 deficiency


People who get B12 def.

o Pernicious anemia – autoantibodies for parietal cells (cause lack of intrinsic factor)
o Gastrectomy/Small bowel resection/Malabsorbtion/IBS affecting distal ileum/Gut bacterial overgrowth – this is where [IF- Vit. B12] receptors are located for absorption
o Chronic pancreatitis – lack of pancreatic enzymes stops release for [B12-haptocorin] for it to attach to intrinsic factor
o Thyroid disease – hypothyroidism causes increase of stomach pH (more basic), thus less release of Vit. B12 from R-binder
o Congenital IF deficiency – no IF means little absorption


Ferrous Sulfate

- treatment of iron deficiency
- oral


Ferrous gluconate

- treatment of iron deficiency
- oral


Iron Dextran

- treatment of acute/severe iron deficiency
- parenteral

o Several concerns with this therapy:
• Anaphylaxis – full history/test dose should be given before starting therapy
• Iron overload – we’re bypassing normal regulatory processes for iron so ferritin/transferrin levels should be monitored to check iron stores/serum iron. If [serum iron>TIBC] then you’re in iron overload
• Adverse side effects – headache, light-headedness, fever, pain, flushing, utricaria, bronchospasm and many more


Major complication of child eating too many iron pills

Necrotizing gastroenteritis


whole bowel irrigation

- Used to flush any unabsorbed iron in acute iron overload



• IV iron chelator that will bind and get iron out of the blood
• Does NOT bind other trace metals
• After administered, [iron+deferoxamine] is excreted in bile/urine; urine is red
• May add to GI and heart problems present in iron toxicity, patient must be monitored to ensure this doesn’t happen


activated charcoal

DON'T USE IT. It doesn't work for acute iron overload


intermittent phlebotomy

- Chronic iron overload
o Patents with hemochromatosis or with multiple blood transfusions are the most common with chronic toxicity
o Bad because iron will build up in the heart, liver, and other organs and kill them
o If anemia is resolved, simply draining blood is the fastest way of lowering iron levels (one unit/week)