Term
| What are the Recombinant human erythropoietin available for therapy? |
|
Definition
Epoetin Alpha
Darbepoetin Alpha |
|
|
Term
| How are Recombinant Erythropoietin administered? What might need to be also supplemented with it? |
|
Definition
IV or SC
May need iron dextran supplement |
|
|
Term
| Erythropoietin is used to treat anemia when it is associated with what? |
|
Definition
Poor erythropoietic response
Surgery - perioperatively
Chemotherapy
AIDS
Premature birth
Chronic inflammatory disease
Chronic renal failure |
|
|
Term
| What stimulates proliferation and differentiation of myeloid cell lines? |
|
Definition
|
|
Term
| What produces Myeloid Growth factors endogenously? |
|
Definition
Fibroblasts
Endothelial cells
Macrophages
T cells |
|
|
Term
| What is the recombinant form of G-CSF (Granulocyte-CSF)? |
|
Definition
|
|
Term
| What agent is useful for severe neutropenia? |
|
Definition
Filgrastim
(can be caused by Bone marrow transplant, high dose chemo, severe congenital neutropenia, AIDS patients of zidovudine) |
|
|
Term
| Why should blood counts be monitored for patients on Myeloid Growth Factors? (Filgrastim, Pegfilgrastim) |
|
Definition
| Monitor granulocyte levels |
|
|
Term
| Which G-CSF agent has a longer half-life? (Filgrastim, Pegfilgrastim) |
|
Definition
|
|
Term
|
Definition
Recombinant form of Interleukin-11
A Megakaryocyte Growth Factor |
|
|
Term
| What does IL-11 stimulate the growth of? |
|
Definition
lymphoid and myeloid cells
Increases platelets and neutrophils |
|
|
Term
| What is IL-11 used to treat? |
|
Definition
|
|
Term
| What kind of anemia does Iron Deficiency cause? |
|
Definition
| Hypochromic microcytic anemia |
|
|
Term
| What is the iron transport protein in blood? |
|
Definition
|
|
Term
|
Definition
Ferritin - Protein iron complex
Hemosiderin - aggregated ferritin |
|
|
Term
| What is the most common cause of Iron Deficiency? |
|
Definition
External Blood Loss
Femal Genital Tract, GI Tract |
|
|
Term
| How is Iron Therapy effectiveness measured? |
|
Definition
by increase RBC production
Reticulocytes increase in 4-7 days
Hemoglobin increase takes longer |
|
|
Term
| Who is prophylactic iron therapy limited to? |
|
Definition
Pregnancy
Women with heavy menstrual cycles
Infants |
|
|
Term
| What is the Iron Therapy of Choice? |
|
Definition
|
|
Term
| What are the common side effects of Iron therapy? |
|
Definition
Heartburn
nausea
upper gastric discomfort
constipation
diarrhea |
|
|
Term
| How is Iron Poisoning treated? |
|
Definition
Induce vomiting and Na-bicarb lavage
Deferoxamine binds iron in blood |
|
|
Term
| When is parenteral Iron indicated? |
|
Definition
Iron Malabsorption
Severe oral iron intolerance
Routine supplement to parenteral nutrition
Patients with renal disease receiving erythropoietin |
|
|
Term
| What are the Parenteral Iron preparations? |
|
Definition
Ferric gluconate comples in sucrose
Iron sucrose
Iron Dextran |
|
|
Term
| What are the side effects of Parenteral Iron? |
|
Definition
Headache
Malaise
Fever
Generalized lymphadenopathy
Arthralgias
Urticaria
Exacerbation of Rheumatoid Arthritis |
|
|
Term
| What does deficiency of Vitamin B12 and Folate lead to? What is an early sign? |
|
Definition
Impaired DNA synthesis
Decreased methionine and S-adenosyl methionine synthesis
Early signs - megaloblastic anemia |
|
|
Term
| What are some causes of Vitamin B12 Deficiency? |
|
Definition
Inadequate Diet - Rare
Gastrectomy, Ileal Resection
Malabsorption States, Gastric Atrophy
Diphyllobothrium Latum - Fish Tapeworm |
|
|
Term
| What is caused by abnormal DNA replication from Vit B12 deficiency? |
|
Definition
Megaloblastic anemia
Irreversible nervous system damage |
|
|
Term
| What is the 2 Vitamin B12 therapy? |
|
Definition
|
|
Term
| What are the 6 Roles of Folic Acid? |
|
Definition
1. homocysteine-> methionine
2. Serine -> Glycine
3. Synthesis of Thymidylate
4. Histidine metabolism
5. Synthesis of purines
6. Utilization or generation of formate |
|
|
Term
| What foods is Folate found in? |
|
Definition
Uncooked Vegetables
Fruits
Liver |
|
|
Term
| Where is Folate absorbed? What can cause malabsorption? |
|
Definition
Upper 1/3 of intestines
Intestinal Disease
Chronic Drugs (Dilantin) |
|
|
Term
| What is Folate Deficiency implicated in? |
|
Definition
Neural Tube defects
Hyperhomocysteinemia |
|
|
Term
| What is the F-formyl derivative of tetrahydrofolate? What is it used for? |
|
Definition
Folinic Acid
Circumvents inhibition of dihydrofolate reductase
Potentiates fluorouracil treatment of colorectal cancer
Conteracts effects of folate antagonists |
|
|
Term
| What drugs might be counteracted by Folic Acid therapy? |
|
Definition
Antiepileptics
Phenobarbital, Phenytoin, Primidone |
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