Pharm anemias.txt

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Author:
Mrfrench
ID:
80583
Filename:
Pharm anemias.txt
Updated:
2011-04-19 19:49:24
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anemias
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Description:
pharmacology associated with anemias
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  1. What drugs interfere w folate absorption
    Phenytoin, isoniazid, sulfasalazine, oral contraceptives
  2. What drugs interfere with folate utilization by inhibiting dihydrofolate reductase
    Methotrexate and trimethoprom
  3. Where is folate stored
    Liver
  4. Should folate be used to treat b12 deficiency?
    No bc b12 deficiency causes neurologic damagr
  5. What are hematopoetic growth factors?
    Glycoprotein hormones that regulate the proloferation and diff of hema progenitor cells in bone marrow
  6. Examples of hema growth factors
    Epo and myeloid growth factors
  7. Hema growth factors
    Recombinant human proteins, treat various forms of hema depression such as leukemia, lymphomas and end stage renal disease, treat bone marrow transplantation and chemo radiation drugs
  8. Epo
    34kd glycoprotein in blood from proximal tubule of kidney, peritubular cells, binds to red cell progeniotrs in bone marrow to increase proliferation and differentiation
  9. What are the uses for EPO
    Anemias w chronic renal failure, anemias w progressive renal fail, anemias AIDS zidovidune, cancer chemo anemias, preop to produce blood for autologous transfusion
  10. Epo adverse effects
    Increase clotting during dialysis, make ppl iron deficient, seizure and htn-can be avoided by using low grad doses of drug
  11. Three ex of myeloid growth factors
    Gc-sf, gm-csf, stem cell factor
  12. G-csf
    Stimulates granulocyte colonies and neutrophil production promotes granulocyte release
  13. Gmcsf
    Stimulates and proliferation of granulocytes and monocytes and macrophages
  14. Stem cell factor
    Survival and prolif of early pluripotent cells
  15. Monocytes colony stimulating factor
    Promotes growth of monocyte prog
  16. Il3
    Stimulates formation of moat hemqtopoetic cell lines
  17. Use of myeloid growth factors
    Recovery of bone marrow after disease or med therapy
  18. Folic acid
    Essential nutrient, tetrahydro precursor needed for purine and thymidylate synthesis
  19. Folic acid deficiency
    Leads to megaloblastic anemia, no neuro damage, impairs dna syn and rapidly dividing cells
  20. Vitamin b12
    Cobalt containing vit 2. Rxns
  21. Vit b12 rxns.
    Methylmalonyl co a mutase- required for conversion of methylmalonyl coa to succinyl coa.....methionine synthetaee
  22. Methylmalonyl coa mutase
    Methylmalonyl coa accumulates incorp into cell membranes gives rise to neuro problems
  23. Methionine synthetaee
    Megloblastic anemia tx with folate
  24. Pernicious anemia
    Deficient intrinsic factor or defect in absorption of b12-if complex in distal ileum in malabsorption syndrome or inflammatory bowel disease
  25. Transcobalamin ii
    Vit b12 transfer protein, stored in liver, only trace amts secreted per day therefore hard to get b12 deficiency...takes yrs to develop
  26. Parenteral iron inducations
    Irin deficiency anemia who cannot toleratw or absorb oral iron, excessive blood loss eho cant be maintained by oral, chrnic renal fail w epo
  27. Iv iron dextran, na ferric gluconate complex, iron sucrose
    Parenteral iv drugs for irom deficiency
  28. What is hereditary hemochromotosis?
    Mutation in hfe gene- protein that interacts with transferrin receptor common in whites most common inherited disorder
  29. What is hematopoeisis?
    The continuous replacement of mature red blood cells
  30. What are the two requirements on hematopoesis?
    • 1. must be responsive to basal needs
    • 2. must be responsive to situations of increased demand
  31. How much can RBC prodcution vary in response to anemia and hypoxia
    5-10x
  32. What three things are reuqired for adequate hematopoesis?
    • 1. iron
    • 2. Vitamin B12
    • 3. Folic acid
  33. Abscence of iron results in which type of anemia?
    Microcytic hypochromic anemia
  34. What is iron used for?
    synthesis of hemoglobin
  35. What is hemoglobin compopsed of?
    Fe-pophyrin and globin chains (humans mostly have HbA)
  36. What type of anemia results from vitamin B12 or folate deficiency?
    megaloblastic anemia
  37. What are the three major causes of anemia?
    • 1. Blood loss
    • 2. Disturbances in RBC production
    • 3. increased destruction of RBCs

    malabsorption problems such as Crohns disease and inflammatory bowel disease can cause an increased need for RBCs.
  38. What is the most common type of anemia?
    iron deficiency
  39. What percentage of iron is present in hemoglobin?
    60-80%
  40. What are the indications for therapeutic use of iron?
    only for iron deficieny anemias such as in children in rapid growth periods and in adults from blood loss for example
  41. Why is oral iron prefered
    because it works just as fast as parenteral and is less likely to cause excessive iron accumulation
  42. Which iron preparation is absorbed the most effieciently?
    ferrous salts (ferrous sulfate and gluconate fumarate)
  43. What drug is used to chelate iron in acute overdose?
    desforaxamine (IV)
  44. What is the transfer form of iron and what is the storage form?
    • transfer= transferrin
    • storage= ferritin

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