Anemia Overview and Treatment
24 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What must accompany folic acid treatment for megaloblastic anemia?

  • Calcium
  • Vitamin C
  • Iron supplementation
  • Vitamin B12 (correct)

What is the primary role of erythropoietin (EPO) in the body?

  • Increase white blood cell counts
  • Stimulate red blood cell proliferation (correct)
  • Enhance iron absorption
  • Regulate blood pressure

What is the primary purpose of myeloid growth factors such as Filgrastim and Pegfilgrastim?

  • To treat anemia by increasing red blood cell production
  • To enhance platelet production during chemotherapy
  • To reduce blood viscosity in sickle cell disease
  • To stimulate granulocyte production and increase neutrophil counts (correct)

Which of the following is true regarding the dosing of myeloid growth factors?

<p>Dosing frequency varies among different agents, with no evidence of superiority (A)</p> Signup and view all the answers

Which of the following is NOT a condition treated by recombinant human erythropoietin (epoetin alfa)?

<p>Anemia associated with liver disease (C)</p> Signup and view all the answers

What is a common adverse effect associated with agents used to treat neutropenia?

<p>Bone pain (C)</p> Signup and view all the answers

What is a known side effect of erythropoietin and darbepoetin therapy?

<p>Elevation in blood pressure (C)</p> Signup and view all the answers

Why should hemoglobin levels not rise more than 1 g/dL over a 2-week period during treatment?

<p>To prevent cardiovascular events (B)</p> Signup and view all the answers

Which agent is specifically classified as a granulocyte-macrophage colony-stimulating factor (GM-CSF)?

<p>Sargramostim (C)</p> Signup and view all the answers

What effect do myeloid growth factors have on neutrophil counts?

<p>They increase neutrophil counts and reduce the duration of severe neutropenia (A)</p> Signup and view all the answers

What is the main difference between epoetin alfa and darbepoetin?

<p>Darbepoetin is long-acting with decreased clearance (B)</p> Signup and view all the answers

What is the role of myeloid growth factors after chemotherapy and bone marrow transplantation?

<p>To reduce the risk of developing neutropenia (D)</p> Signup and view all the answers

Which of the following treatment recommendations is advised for patients receiving epoetin alfa or darbepoetin?

<p>Reduce doses if hemoglobin exceeds 10 g/dL (D)</p> Signup and view all the answers

What is the effect of hypoxia on the production of erythropoietin?

<p>It stimulates EPO production (A)</p> Signup and view all the answers

Which of the following statements about the efficacy of different myeloid growth factor agents is correct?

<p>There is no evidence showing superiority of one agent over others (D)</p> Signup and view all the answers

During what scenario are agents used to treat neutropenia most commonly administered?

<p>Prophylactically following chemotherapy and bone marrow transplantation (B)</p> Signup and view all the answers

What is the primary role of transferrin in the body?

<p>Delivering iron to the bone marrow for hemoglobin production (C)</p> Signup and view all the answers

Which type of anemia is caused specifically by iron deficiency?

<p>Hypochromic microcytic anemia (B)</p> Signup and view all the answers

What is a common sign or symptom of anemia?

<p>Insomnia (D)</p> Signup and view all the answers

Which vitamin is specifically mentioned as a treatment for anemia?

<p>Vitamin B12 (Cyanocobalamin) (B)</p> Signup and view all the answers

What daily dosage of elemental iron is recommended for treating iron deficiency anemia?

<p>150 to 180 mg/day (D)</p> Signup and view all the answers

What condition can result from iron deficiency that involves unusual cravings?

<p>Pica (C)</p> Signup and view all the answers

In which part of the body is iron primarily absorbed after oral administration?

<p>Duodenum (B)</p> Signup and view all the answers

Which of the following can cause iron deficiency due to increased demand?

<p>Insufficient intake during pregnancy (B)</p> Signup and view all the answers

Flashcards

What are myeloid growth factors?

Drugs used to increase production of neutrophils, a type of white blood cell, in the bone marrow.

How do myeloid growth factors work?

These agents stimulate granulocyte production in the bone marrow, leading to increased neutrophil counts and shorter duration of severe neutropenia.

Name some examples of myeloid growth factors.

Filgrastim, Tbo-filgrastim, and Pegfilgrastim.

What is hydroxyurea?

A drug used to treat sickle cell disease by increasing fetal hemoglobin levels.

Signup and view all the flashcards

How does hydroxyurea work?

Hydroxyurea increases fetal hemoglobin levels, diluting the abnormal hemoglobin S (HbS) in sickle cell disease.

Signup and view all the flashcards

What are some side effects of hydroxyurea?

Hydroxyurea can cause bone marrow suppression and cutaneous vasculitis.

Signup and view all the flashcards

What is pentoxifylline?

Pentoxifylline is a methylxanthine derivative that increases the deformability of red blood cells and reduces blood viscosity.

Signup and view all the flashcards

What are some uses for pentoxifylline?

Pentoxifylline is used to treat intermittent claudication and may also be helpful in diabetic angiopathies, transient ischemic attacks, sickle cell anemias, strokes, and Raynaud's phenomenon.

Signup and view all the flashcards

Pernicious anemia

Anemia caused by a deficiency in vitamin B12 that occurs when the body cannot absorb vitamin B12 properly.

Signup and view all the flashcards

Megaloblastic anemia

A type of anemia characterized by abnormally large red blood cells, typically caused by a deficiency in vitamin B12 or folic acid.

Signup and view all the flashcards

Erythropoietin (EPO)

A hormone produced mainly by the kidneys that stimulates the production of red blood cells.

Signup and view all the flashcards

Epoetin alfa

A synthetic version of erythropoietin used to treat anemia caused by various conditions including chronic kidney disease, HIV infection, and cancer.

Signup and view all the flashcards

Darbepoetin

A long-acting version of erythropoietin with a longer half-life than epoetin alfa, used to treat anemia in similar conditions.

Signup and view all the flashcards

Anemia

A condition where the body lacks enough healthy red blood cells to carry adequate oxygen to the tissues.

Signup and view all the flashcards

Erythropoiesis

The process by which the body produces red blood cells.

Signup and view all the flashcards

Iron deficiency anemia

A condition characterized by a deficiency in iron, often leading to anemia.

Signup and view all the flashcards

What is anemia?

Anemia is a condition characterized by a decrease in hemoglobin or red blood cell count, resulting in reduced oxygen-carrying capacity of the blood.

Signup and view all the flashcards

What are the signs and symptoms of anemia?

Common signs and symptoms include fatigue, rapid heartbeat, shortness of breath, pale skin, dizziness, and insomnia.

Signup and view all the flashcards

What is iron deficiency anemia?

Iron deficiency anemia occurs when the body lacks sufficient iron to produce enough hemoglobin for red blood cells.

Signup and view all the flashcards

What causes iron deficiency anemia?

Iron deficiency anemia can result from chronic blood loss, inadequate intake, or increased iron requirements during periods of rapid growth or pregnancy.

Signup and view all the flashcards

How is iron absorbed?

Iron is absorbed in the duodenum, and its absorption is influenced by the body's iron stores. Dietary iron is converted to the more soluble ferrous form in the stomach.

Signup and view all the flashcards

What type of anemia does iron deficiency cause?

Iron deficiency anemia can lead to hypochromic microcytic anemia, characterized by smaller red blood cells with less color.

Signup and view all the flashcards

How is iron deficiency anemia treated?

Oral iron supplementation is the primary treatment for iron deficiency anemia, typically administered in divided doses two to three times daily.

Signup and view all the flashcards

What are some additional symptoms of iron deficiency anemia?

Iron deficiency anemia may cause Pica, Koilonychias, and soreness at the corners of the mouth.

Signup and view all the flashcards

Study Notes

Anemia Overview

  • Anemia is a reduction in hemoglobin or red blood cell count.
  • Physiologically, anemia is any disorder causing tissue hypoxia due to decreased blood oxygen-carrying capacity.
  • Common symptoms include fatigue, rapid heartbeat, shortness of breath, pale skin, dizziness, and insomnia.
  • Causes of anemia include chronic blood loss, bone marrow abnormalities, increased hemolysis, infections, malignancy, endocrine deficiencies, renal failure, drug toxicity, dietary deficiencies (iron, folic acid, vitamin B12), and genetic conditions (sickle cell disease).

Drugs for Anemia

  • Agents used to treat anemias: Iron, Vitamin B12 (cyanocobalamin), folic acid, and erythropoietin.

Iron

  • Iron is stored in mucosal cells, liver, spleen, and bone marrow as ferritin (iron-protein complex).
  • Iron is transported to the marrow for hemoglobin production by the transport protein transferrin.
  • Iron deficiency can result from acute or chronic blood loss, insufficient intake (especially during growth spurts in children and pregnancy), or heavy menstruation.
  • Iron deficiency causes hypochromic microcytic anemia (small, pale red blood cells).
  • Symptoms of iron deficiency anemia may include pica (craving for non-nutritive substances), koilonychias (spoon-shaped nails), and soreness/cracking at the corners of the mouth.
  • Treatment: 150-180 mg of oral elemental iron daily, divided into two to three doses.
  • Iron absorption: Absorption occurs in the stomach (acidic conditions keep iron in the reduced ferrous form, which is more soluble), then the duodenum. Absorption depends on body iron stores - if stores are adequate, less iron will be absorbed; if low, more iron will be absorbed.
  • Lower doses are usually recommended.
  • Oral iron preparations include ferrous sulfate, ferrous fumarate, ferrous gluconate, and polysaccharide-iron complex/carbonyl iron formulations.
  • Parenteral iron formulations (iron dextran, sodium ferric gluconate, iron sucrose) are also available, and they are absorbed more rapidly than oral preparations.
  • Adverse effects of iron supplementation include gastrointestinal disturbances (abdominal pain, constipation, diarrhea) and dark stools.
  • Caution to patients with hypersensitivity to iron, especially iron dextran. Test dose should be administered prior to iron dextran.

Folic Acid (Folate)

  • Folic acid is used to treat folate deficiency states.
  • Causes of folate deficiency include high demand (pregnancy, lactation), poor absorption (intestinal pathology), alcoholism, and certain medications (dihydrofolate reductase inhibitors like methotrexate).
  • Folic acid deficiency leads to megaloblastic anemia (large, immature red blood cells).
  • Absorption occurs in the jejunum.
  • Excessive folic acid intake is excreted in urine and feces; oral folic acid is non-toxic.

Vitamin B12 (Cyanocobalamin)

  • Vitamin B12 deficiency can result from low dietary intake, poor absorption (due to the failure of gastric parietal cells to produce intrinsic factor, leading to pernicious anemia), or loss of receptor activity for intestinal uptake.
  • Conditions like gastric resection can also result in Vitamin B12 deficiency
  • Symptoms of B12 deficiency anemia include tingling in hands and feet, difficulty walking, dementia, hallucinations, paranoia, and even schizophrenia.
  • The vitamin can be given orally, via sublingual tablets, intramuscularly, or deep subcutaneously (especially for pernicious anemia).
  • Important to note: Administering folic acid alone for megaloblastic anemia can mask Vitamin B12 deficiency and lead to neurological damage. Treatment must consider the cause for a specific treatment, and typically requires continued lifelong therapy for pernicious anemia.

Erythropoietin and Darbepoetin

  • Kidneys produce EPO, which stimulates red blood cell production.
  • EPO effectively treats anemia caused by end-stage renal disease, HIV infection, bone marrow disorders, prematurity, and some cancers.
  • Darbepoetin is a long-acting form of EPO, with a longer half-life.
  • Side effects include increased risk of cardiovascular events (thrombosis, hypertension, increased death risk) when high hemoglobin levels are targeted.
  • Dosages should be carefully monitored.

Agents to treat Neutropenia:

  • Myeloid growth factors or granulocyte colony-stimulating factors (G-CSF): Filgrastim, Tbo-filgrastim, and Pegfilgrastim
  • Granulocyte-macrophage colony-stimulating factors (GM-CSF): Sargramostim These primarily stimulate granulocyte production in bone marrow to increase neutrophil counts and improve the duration of severe neutropenia.

Hydroxyurea

  • Often used to treat sickle cell anemia.
  • Action: Increases fetal hemoglobin, which reduces the presence of abnormal hemoglobin S.
  • Side effects: Bone marrow suppression, and cutaneous vasculitis.

Pentoxifylline

  • Methylxanthine derivative
  • Increases red blood cell deformability (flexibility) and reduces viscosity.
  • This decreases total systemic vascular resistance, improves blood flow, and enhances tissue oxygenation, particularly useful for peripheral vascular disease.
  • Primarily indicated to treat intermittent claudication. It may be used in other disorders like diabetic angiopathies, transient ischemic attacks, sickle cell anemias, and Raynaud's phenomenon.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

Drugs for Anemia PDF

Description

This quiz covers the essentials of anemia, including its causes, symptoms, and the physiological impact on the body. It also highlights the drugs used for treating anemia, particularly the role of iron and vitamins in hemoglobin production. Test your knowledge on this important health topic!

More Like This

Use Quizgecko on...
Browser
Browser