PHARMACOLOGY 1

Question 1

Oral Iron theraby drugs are:

Answer 1

1-Ferrous sulphate
2-Gluconate
3-Fumarate
4-Carbonyl iron

Question 2

What is the definition of elemental iron

Answer 2

It is the amount (percentage) of iron in supplements availabe for absorption by the body

Question 3

which orally absorbed iron theraby has 100% elemental iron

Answer 3

Carbonyl Iron -150mg-

Question 4

What are the adverse effects of oral iron theraby

Answer 4

1.GIT disturbance: nausea, epigastric pain, constipation
2. Black stools ——> masks the diagnosis of GastroIntestinal Bleeding
3. Black teeth stains ——-> Due to iron sulfide

Question 5

What are the indications for Parentral Iron Theraby

Answer 5

1-Non-compliance to oral theraby
2- Malabsorption syndrome—–> causing failure of iron absorption
3-Severe anemia, e.g.malignancy

Question 6

What are parentral Iron Preperations

Answer 6

1-Iron Dextran
2-Iron sucrose complex & Iron sodium gluconate complex
3-Ferric Carboxymaltose,Ferumoxytol (Given as Deep IM or Total dose IV infusion)

Bold drugs are on the drug list

Question 7

What are the Advantages of Total Dose Infusion

Answer 7

1-Avoids patients non-compliance
2-Avoids unpleasent effects of IM
3-Delivery of entire necessary Iron dose to correct iron defficincy at one time

Question 8

What are the adverse effects of Parentral Iron Theraby

Answer 8

IM: Local Pain & tissue staining
IV: Headache,Fever,urticaria,Lymphadenopathy& anaphylactic shock

Question 9

What are the symptoms of Acute Iron toxicity (more common in children)

Answer 9

Abdominal pain, Vomiting, Bloody diarrhea, Dyspnea followed by metabolic acidosis, cardiovascular collapse, convulsions, coma & death

Question 10

What are Acute Iron toxicity treatments (immediately)

Answer 10

1- Raw egg or milk ———> bind to iron temporarily till chelating agent is available

2- Deferoxamine ———> a.given as 1-2 g IM _or_ IV chelating iron to be excreted in urine

b. 5g in 100ml water swallowed or by stomach tube (after gastric lavage by bicarbonate solution)

3-IV infusion of saline, dextrose or bicarbonate

Question 11

Who are the patients with Chronic Iron toxicity

Answer 11

1- Patients receiving many red cell transfusion

2- patients with hemocromatosis

Question 12

Management of Chronic Iron Toxicity

Answer 12

1- Venesection (if no anemia) repeated weekly

2- Iron Chelators :
Deferoxamine —-> IM or SC
Deferasirox

3- large intake of tea ——-> tannins (tanic acid) bind to iron

Question 13

What is the treatment of Aplastic anemia

Answer 13

Erythropoietin (IV or SC)

Question 14

What is the preparation of choice of Vitamin B12

Answer 14

Hydroxycobalamin——> 1. more slowly absorbed
2. More bound to plasma proteins
3. slowly excreted
4. more sustained rise in serum cobalamine

Question 15

What are the therapeutic uses of folic acid (Vitamin B9)

Answer 15

1. Nutritional megaloblastic anemia
2. Malabsorption syndrome
3. In alcoholic and pregnant women
4. patients with liver disease & hemolytic anemia
5. with anticonvulsant drugs
6. patients on dialysis