Haemanitics And Erythropoietin Flashcards

1
Q

Which substances inhibit iron absorption

A
  1. Excess phosphate
  2. excess oxalates
  3. excess phyates
    Form insoluble complexes
  4. Milk
  5. antacids
  6. tetracyclines
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2
Q

What are the various oral preparation of iron

A
  1. Ferrous sulphate
  2. Ferris gluconate
  3. ferrous fumarate
  4. Colloidal ferric hydroxide
  5. Carbonyl iron 
  6. Ferrous succinate
  7. iron choline citrate
  8. ferric ammonium citrate
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3
Q

What are the adverse effects of Oral iron preparations

A
  1. Nausea, vomiting
  2. epigastric discomfort
  3. dyspepsia
  4. metallic taste
  5. constipation or diarrhoea
  6. staining of teeth
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4
Q

Name parental preparations of iron

A
  1. Iron sorbitol citric acid complex (jectofer)
  2. Iron dextran (imferon)
  3. Ferrous sucrose
  4. ferric carboxymaltose
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5
Q

What are the indications for parental iron therapy

A
  1. Intolerance to oral iron
  2. malabsorption of oral iron
  3. noncompliance to oral iron
  4. severe iron Deficiency
  5. along with erythropoietin in patients with renal disease
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6
Q

How do you calculate total dose of parentental iron

A

Total iron = 4.4 x body weight x HB deficit

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7
Q

Which parental iron preparation contains nano particles of iron oxide

A

Ferric carboxy maltose

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8
Q

What are the adverse effects of parental iron preparation

A
  1. Pain at injection site
  2. abscess and discolouration of skin at the side of injection
  3. headache, pyrexia, nausea, vomiting
  4. Arthralgia
  5. lymphadenopathy
  6. Uriticaria
  7. anaphylactic reaction
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9
Q

What are the therapeutic uses of iron

A
  1. To treat Iron deficiency:
    a) during pregnancy
    b) due to blood loss
    c)due to nutritional deficiency
    d) due to poor absorption of iron from the gut
  2. prophylaxis: pregnancy and infancy
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10
Q

What are the manifestations of acute iron poisoning

A
  1. Nausea, vomiting, epigastric pain
  2. bloody diarrhoea
  3. dehydration
  4. cyanosis
  5. drowsiness
  6. hyperventilation
  7. metabolic acidosis
  8. conversions, coma and death
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11
Q

Which drugs are useful in iron poisoning

A
  1. Desferrioxamine
  2. Deferiprone
  3. Calcium edetate
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12
Q

How do you treat iron poisoning

A
  1. General Measures
  2. specific therapy
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13
Q

What are the procedures for general measures for iron poisoning

A
  1. Supportive measures: airway, breathing, circulation, fluid and electrolyte balance should be maintained
  2. vomiting induced. gastric lavage- Sodium bicarbonate precipitates iron and reduces its adoption
  3. IV diazepam to control convulsions
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14
Q

What are the measures taken for specific therapy for iron poisoning

A

1. Desferrioxamine, A potent iron chelating agent IV
OR
2. Deferiprone oral iron chelator
IR
3. Calcium edetate

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15
Q

What are the manifestations of vitamin B 12 deficiency

A
  1. megaloblastic anaemia pallor of skin and mucous membranes
  2. Degeneration of posterior and lateral columns of spinal cord
  3. paresthesia, peripheral neuropathy, confusion, loss of memory, hallucination and psychosis
  4. Glossitis, atrophy of tongue and vagina
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16
Q

What are the preparation of vitamin B 12

A
  1. Cyanocobalamin
  2. Hydroxocobalamin (I.M)
  3. methylcobalamin
17
Q

Administration of folic acid alone in vitamin B 12 deficiency correct megaloblastic anaemia by aggravates or precipitates what

A

Neurological abnormalities

18
Q

What are the uses of preparations of vitamin B 12

A
  1. Pernicious anaemia
  2. Treatment for diabetic neuropathy
  3. Other neuropathies
  4. Prophylactic therapy
  5. Tobacco amblyopia
19
Q

What are the causes of folate deficiency

A
  1. Dietary deficiency
  2. decreased absorption
  3. diminished storage
  4. decreased utilization
  5. increase demand
  6. drug induced
20
Q

What causes diminished storage of folate deficiency

A

Hepatic disease, vitamin C deficiency

21
Q

What leads to folate deficiency Caused by decreased utilization

A
  1. Phenytoin
  2. phenobarbital
22
Q

In what states is there an increased demand of folate

A
  1. Pregnancy
  2. lactation
  3. haemolytic anaemia
23
Q

Which drugs Induce folate deficiency

A

Anti-folates:
1. Methotrexate
2. trimethoprim
3. Pyrimethamine

24
Q

What are the signs of folate deficiency

A
  1. Megaloblastic anaemia
  2. Glossitis, diarrhea, general weakness and weight loss
25
Q

Which drug is used in the treatment of methotrexate toxicity and as an adjuvant to methanol poisoning

A

Folinic acid (Calcium leucovorin)

26
Q

What are the uses of folate

A
  1. Megaloblastic anaemia due to
    a)nutritional folate deficiency
    b)increase demand [pregnancy and lactation]
    c)pernicious anaemia along with vitamin B 12
  2. prophylactic therapy
  3. methotrexate toxicity
  4. to increase anticancer effect of 5-fluorouracil, folinic acid is coadministered
27
Q

Name the preparations available for erythropoietin

A
  1. Epoetin alfa
  2. Darbepoetin alfa 
28
Q

Name haematopoietic growth factors

A
  1. Erythropoietin
  2. myeloid growth factors
  3. thrombopoietic growth factors
29
Q

Name Erythropoietin analogues

A
  1. Epoetin Alfa
  2. Darbepoetin Alfa
30
Q

Give example of myeloid growth factors

A

Human granulocyte colony stimulating factor

31
Q

Give examples of thrombopoetic growth factors

A

Interleukin - 11(oprelvekin) and recombinant thrombopoietin

32
Q

What is the function of erythropoietin

A

Stimulates erythrpoiesis 

33
Q

What is the use of Erythropoietin

A

Anaemia associated with:
1. Renal failure
3. anticancer drugs
3. zidovudine induced anaemia in HIV patients

34
Q

What is the function of myeloid growth factor

A

Stimulates proliferation and differentiation of WBCs

35
Q

What is the function of Throbopoietic growth factors

A

Stimulates production of platelets

36
Q

What is the use of myeloid growth factor

A

Patients who’s WBCs are suppressed by anti-cancer and antiretroviral drugs

37
Q

What is the use of thrombopoetic growth factors

A

To treat cancer chemotherapy induced thrombocytopenia

38
Q

What are the adverse effects of haematopoietic growth factors

A
  1. Hypertension
  2. haematocrit and thromboembolic complications
  3. allergic reactions flu like symptoms
  4. nausea, vomiting and tachycardia