Topic 12 Anemia Flashcards
(22 cards)
Anemia Therapeutics
Iron
B12
Folic Acid (B9)
Erythropoietin (Epogen, Procrit)
Why is Iron a treatment of Anemia?
Required for the hemoglobin molecule to carry
O₂
Iron deficiency results from inadequate iron stores &/or intake.
Iron is stored in what?
Stored in intestinal mucosal cells as ferritin.
Oral Iron supplement adverse effects?
Injections HURT!
Oral iron supplements can cause “GI upset”
Iron deficiency anemia classically causes what kind of anemia?
hypochromic, microcytic anemia
Folate (B9) deficiencies are caused by what?
pregnancy, lactation, intestinal pathology (Crohn’s Disease, etc.) preventing absorption, alcoholism, certain drugs.
Folate is require for DNA synthesis
Folate deficiency anemia classically causes what type of anemia
megaloblastic anemia
Most common cause of deficiency is what?
poor B₁₂ absorption aka “pernicious anemia”
pernicious anemia
poor B₁₂ absorption
B₁₂ deficiency also causes what type of anemia
megaloblastic anemia
Therapies for megaloblastic anemia
B₁₂ and Folate
Epogen and Procrit (Erythropoietin) are what chemically?
Both are synthetic forms of erythropoietin-alfa
•Both have identical protein structure and vary in their glycosylation
Darbepotin (Aranesp)
is a longer-acting cousin of Epogen and is “albumin-free”
•Part of a comprehensive blood. conservation/blood management program.
•Require week(s) to “kick in” bone marrow so not appropriate for acute blood loss.
•Usually given with iron
Darbepotin
(Aranesp)
Darbepotin (Aranesp) side affects?
High potential for abuse! –Stroke –Increased tumor risk –Thromboembolic events –Severe HTN–Death
Sickle cell drugs?
Hydroxyurea (Hydrea, Droxia)
Pentoxifylline (Trental)
Hydroxyurea
Hydrea, Droxia
Sickle cell drugs
Pentoxifylline
Trental
Sickle cell drugs
Hydroxyurea (Hydrea, Droxia) - how does it work?
Fairly effective in preventing painful acute
“crises” associated with sickling claudication.
*Causes sickle cell hemoglobin (HbS) to get diluted by an increased production of fetal hemoglobin (HbF) particularly when used with epo-alfa
Claudication
Pain caused by too little blood flow
Pentoxifylline is what kind of modifier
rheologic modifier!
-It increases the “flexibility” of RBC’s so they are less likely to clog capillaries
Pentoxyifylline does what?
Decreases blood viscosity so interesting future possibilities…TIA, strokes, Raynaud’s, diabetic ulcers, etc
