Iron

Question 1

Erythropoietin stimulating Agonist (ESA)

(Darbepoetin, eopetin, epoetin, methoxy pegepoetin)

Answer 1

MOA: binds to erythropoietin receptors on erythroid progenitor cells stimulating proliferation and differentiation of erythroid cells and stimulate iron uptake and haeme-biosynthesis in erythroid progenitor cells

Side effect: increase the risk of VTE, cardiovascular issues - hypertension, heart failure, stroke use with caution

Contraindicated in uncontrolled hypertension (may worsen)

Question 2

Iron

Answer 2

MOA: Essential element required for the formation of haemoglobin and myoglobin.

Pregnant and breast feeding is safe, but avoid parental iron in 1st trimester.

Side effect: vomiting, constipation, diarrhoea, taste disturbance, nausea,

Question 3

Folic acid

Answer 3

MOA: The intestinal mucosal cells or hepatocytes are reduce and methylate folate can be used in DNA synthesis

Pregnancy and breast feeding safe

Question 4

Vitamin B12

Answer 4

MOA: nucleic acid synthesis and normal erythropoiesis.

Question 5

Chelating iron

(Deferasirox, defiroprone, desferrioxamine

Answer 5

MOA: promote iron excretion by forming a complex with non-transferrin-bound iron; elimination by faecal matter. This decreases the amount of stored iron and prevents continuous distribution of iron to key tissues via plasma non-transferrin-bound iron.

Indications
Treatment of chronic iron overload, eg due to multiple blood transfusions