-
What are agents of erythropoiesis stimulating agents (ESA)?
- Epoetin alfa
- Darbepoetin alfa
-
What is the mechanism of action for erythropoiesis-stimulating agent?
Bind erythropoietin receptors
-
What are the three pathways that can lead to increased erythrocyte production?
- RAS
- STAT
- AKT
- These can lead to changes in gene expression that increases survival and proliferation
-
What is secondary anemia?
Secondary to CKD is an example, this is when not enough EPO is produced by the kidney due to a kidney disease and lead to subsequent anemia
-
What is HIF? And what happens to level of HIF in the blood when there is decreased oxygen?
- HIF is hypoxia inducible factor
- Level of HIF increases with low oxygen and this would stimulate EPO release
-
What are therapeutic uses for ESA? Erythropoiesis stimulating agent?
- Secondary anemia CKD
- Prevent transfusions (reduce the need for transfusion)
- Cancer patients myelosuppressive therapy
- HIV patients
-
Which drug is used so to prevent the need for transfusions?
ESAs (erythropoiesis stimulating agents)
-
Which drug is used to treat secondary anemia?
- ESAs (erythropoiesis stimulating agents)
- Used to treat anemia secondary to chronic kidney disease
-
Which drug can be used for HIV patients?
ESA, specifically Zidovudine
-
What is the difference in half life between ESAs: Darbepoetin alfa and epoetin alfa?
Darbepoeitin alfa has longer half life than epoetin alfa, thus Darbepoietin only need is once a week vs epoetin alfa calls for 3x a week
-
What are adverse effects of ESA?
- Thrombotic complications
- Hypertension
- BLACK BOX WARNING- Increased risk for MI, stroke, venous thromboemobolism, thrombosis of vascular access and tumor progression or recurrence
-
What is the black box warning for ESA?
Increase the risk of death, MI, Stroke, Venous thromboembolism, thrombosis of vascular access and tumor progression or recurrence
-
What is the recommended dosage for ESA?
The lowest dose possible because of its black box warning that it will basically kill you
-
What are the agents for iron deficiency oral treatment?
- Ferrous sulfate
- Ferrous gluconate
- Ferrous fumerate
-
What are adverse effects of oral iron?
- Black stools
- CHILD POISONING
- GI: n/v/c
-
T/F: IV iron has an adverse side effect of poisoning children?
False; oral iron poisons children
-
What are agents of IV/ parenteral iron?
- Iron dextran
- Sodium, ferric gluconate complex
- Iron sucrose complex
-
How do you tell the difference between IV and oral iron in terms of the names of their agents?
- Oral iron the agents have “ferrous” in the name
- IV/Parenteral does not
-
What are the therapeutic indications for IV/parenteral iron?
- Patients unable to tolerate or absorb oral iron
- Extensive chronic anemia
-
What is the first thing you do when giving pts IV / parenteral iron?
always test dose to see if there is hypersensitivity
-
What are adverse effects of IV/parenteral iron?
- Joint pain
- Headache
- ANAPHYLAXIS (associated with high molecular form of iron dextran)
- GI: n/v
-
What are the agents of drug that is used for iron toxicity?
-
What is the mechanism of action for Deferoxamine (an iron toxicity drug)
Potent iron-chelating drug that promotes iron excretion
-
What is the therapeutic indication for deferoxamine?
Iron overload
-
When there is iron overload, which drug do you use?
- Deferoxamine
- Even though phlebotomy is better
-
What are adverse effects of deferoxamine?
- Orange and red urine
- GI: n/v
-
What is the agent used for Vitamin B12 deficiency to combat neurological symptoms?
Cyanocobalamin
-
What is cyanocobalamin?
A drug to treat neurological manifestation as a result of vitamin B12 deficiency
-
What are some neurological symptoms as a result of vitamin B12 deficiency?
- paresthesia
- Ataxia
- Spasticity
- Weakness
-
What do you use to treat folic acid deficiency?
uh.. folic acid.
|
|