Pharmacology I: Hematinics & Hematopoietic Drugs
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

Which agent is known to stimulate fetal hemoglobin (HbF) expression significantly?

  • Imatinib
  • Decitabine (correct)
  • Arsenic Trioxide
  • Thalidomide

    • What is the mechanism by which 5-azacytidine increases fetal hemoglobin production?

  • Direct gene activation
  • Protein synthesis inhibition
  • Epigenetic modification (correct)
  • Reduction in erythropoietin levels

    • What therapeutic goal is associated with increasing fetal hemoglobin (HbF) levels?

  • Lowering blood pressure
  • Reducing sickle cell crises (correct)
  • Enhancing oxygen delivery
  • Decreasing iron overload

    • How do butyrates function in relation to fetal hemoglobin?

    <p>They prevent the switch from HbF to HbS (B)</p> Signup and view all the answers

    Which of the following conditions may lead to low neutrophil counts or neutropenia?

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

    What fetal hemoglobin (HbF) level is suggested to make a patient with sickle cell anemia asymptomatic?

    <p>30-40% (A)</p> Signup and view all the answers

    Which statement about the action of 5-azacytidine is correct?

    <p>It leads to hypomethylation of the gamma globin gene. (D)</p> Signup and view all the answers

    Which therapeutic agent is often used to address sickle cell disease in adults by inducing HbF production?

    <p>Hydroxyurea (A)</p> Signup and view all the answers

    What is the primary indication for agents that induce fetal hemoglobin (HbF)?

    <p>Patients with sickle cell disease (D)</p> Signup and view all the answers

    At what age do patients with sickle cell disease begin to show symptomatic manifestations?

    <p>At age 2 (A)</p> Signup and view all the answers

    What is the typical level of fetal hemoglobin (HbF) in adults with sickle cell disease?

    <p>1-5% (C)</p> Signup and view all the answers

    What role does eumelanin play in influencing the clinical manifestations of sickle cell disease?

    <p>It is unrelated to sickle cell disease. (B)</p> Signup and view all the answers

    What is a consequence of fetal globin gene expression persisting in newborns with sickle cell disease?

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

    Why are butyrates not effective in inducing HbF if the baseline HbF is less than 1%?

    <p>They require a certain threshold of HbF for efficacy. (D)</p> Signup and view all the answers

    What does the increased levels of HbF in children imply for the treatment of sickle cell disease?

    <p>Higher HbF is associated with better symptom management. (C)</p> Signup and view all the answers

    What is a potential effect of agents that induce fetal hemoglobin (HbF) on sickle cell disease clinical outcomes?

    <p>They may reduce frequency of pain crises. (C)</p> Signup and view all the answers

    What is the major effect of hydroxyurea in the treatment of sickle cell anemia?

    <p>Decreases the frequency of sickle cell crises (A)</p> Signup and view all the answers

    Which agents are known to stimulate leukocyte production?

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

    How does ribonucleotide reductase relate to the treatment of sickle cell anemia?

    <p>It is inhibited by hydroxyurea to block cell division (A)</p> Signup and view all the answers

    What role does fetal hemoglobin (HbF) play in sickle cell disease management?

    <p>It helps in decreasing the frequency of sickle cell crises (A)</p> Signup and view all the answers

    Which of the following statements about azacytidine is true?

    <p>It has a secondary 2-carbon hydroxyl group (B)</p> Signup and view all the answers

    What is a less common cause of neutropenia mentioned in the treatment considerations?

    <p>Bone marrow transplant (B)</p> Signup and view all the answers

    Which drug was primarily used in the 1990s for the treatment of sickle cell anemia?

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

    Which condition may accompany leukemia and is associated with myelosuppression?

    <p>Neutropenia (A)</p> Signup and view all the answers

    Flashcards

    Fetal Hemoglobin (HbF)

    A type of hemoglobin found in newborns and infants, which can persist for months after birth.

    Sickle Cell Disease

    A genetic disorder causing abnormal red blood cells and episodes of pain.

    HbS

    Sickle hemoglobin, a form of hemoglobin that causes sickle cell disease.

    Acute Pain Crises

    Episodes of severe pain associated with sickle cell disease.

    Signup and view all the flashcards

    Hemolytic Anemia

    A condition where red blood cells are destroyed faster than they are produced.

    Signup and view all the flashcards

    Fetal Globin Gene Expression

    The process of the fetus's body producing fetal hemoglobin.

    Signup and view all the flashcards

    HbF Levels in Sickle Cell

    Newborns and infants have higher HbF levels, decreasing as they age.

    Signup and view all the flashcards

    Epigenetic Mechanisms

    Processes that affect gene expression without changing the DNA sequence.

    Signup and view all the flashcards

    Sickle Cell Anemia

    A genetic disorder causing red blood cells to become sickle-shaped, leading to pain and anemia.

    Signup and view all the flashcards

    5-azacytidine

    A DNA methylating agent that increases HbF production, aiding treatment of sickle cell anemia and beta thalassemia.

    Signup and view all the flashcards

    DNA Methylation

    A process where a methyl group is added to DNA, affecting gene expression.

    Signup and view all the flashcards

    Butyrates

    Substances that can prevent the switch from HbF to HbS, potentially aiding sickle cell anemia.

    Signup and view all the flashcards

    Myeloid Growth Factors

    Substances that stimulate the production of leukocytes (WBCs).

    Signup and view all the flashcards

    Neutropenia/Neutrophilia

    Low or high neutrophil (a type of white blood cell) counts. Indicates problems with stem cell development into mature WBCs.

    Signup and view all the flashcards

    What inhibits cell division in hydroxyurea?

    Hydroxyurea blocks cell division by inhibiting ribonucleotide reductase, an enzyme critical for DNA synthesis.

    Signup and view all the flashcards

    Hydroxyurea's impact on sickle cell crises

    Hydroxyurea reduces the frequency of sickle cell crises by 50% by increasing fetal hemoglobin (HbF) levels

    Signup and view all the flashcards

    What is ribonucleotide reductase's role?

    Ribonucleotide reductase converts ribonucleotides (RNA building blocks) into deoxyribonucleotides (DNA building blocks).

    Signup and view all the flashcards

    Neutropenia: Potential causes

    Neutropenia (low neutrophil count) can occur due to myelosuppression, leukemia, malignancies, bone marrow transplant, congenital neutropenia, HIV, Zidovudine, and more.

    Signup and view all the flashcards

    How do Filgrastim and Sargramostim work?

    They are drugs that stimulate leukocyte production by mimicking natural growth factors G-CSF and GM-CSF.

    Signup and view all the flashcards

    What is the difference between azacytidine and decitabine?

    Azacytidine has an extra 2-carbon hydroxyl group compared to decitabine.

    Signup and view all the flashcards

    Decitabine

    A drug used for MDS and AML. It inhibits DNA methylation and has a slightly different chemical structure than azacytidine.

    Signup and view all the flashcards

    Study Notes

    Pharmacology I: Hematinics & Hematopoietic Drugs

    • Hematinics are vitamins, nutraceuticals, or dietary factors vital for hemoglobin (Hb) synthesis or erythrocyte production.
    • Iron deficiency anemia (IDA) is the most common nutritional deficiency globally, affecting up to 1 billion people.
    • IDA results from insufficient dietary iron intake, impacting labor capacity, growth, and learning in children and causing cyclical menstrual issues in women.
    • Each pregnancy results in 500 mg iron loss, necessitating supplementation.
    • Iron absorption is regulated by absorptive enterocytes in the small intestine.
    • Optimal iron absorption from a typical diet is 1 mg (10% of 10-20 mg daily intake).
    • Iron is incorporated into hemoglobin (2.5 g in males, 1.7 g in females).
    • Iron is stored as ferritin (intracellularly) and hemosiderin (partially oxidized ferritin).
    • Non-heme iron (ferric) needs conversion to ferrous form for absorption from plant sources.
    • Dietary sources of iron include beef, chicken, oysters, shrimp, tuna, black-strap molasses, raisin bran cereal, raisins, prune juice, prunes, potatoes (with skin), kidney beans, lentils, tofu, and cashew nuts.
    • Women require more iron due to menstruation, with 50% of pregnant women showing iron deficiency.
    • Megaloblastic anemia arises from vitamin B12 (cobalamin) or folate (vitamin B9) deficiency.
    • Vitamin B12 deficiency correlates with pernicious anemia (due to intrinsic factor absence leading to poor absorption).
    • Folate deficiency is associated with alcoholism, liver disease, malabsorption, and some medications.
    • Increased intake of folic acid during pregnancy helps prevent neural tube defects in fetuses.
    • Parenteral iron therapy is necessary if oral iron is poorly tolerated or required quickly.
    • Oral iron therapy involves simple or complex iron compounds.
    • Oral iron is absorbed in the gut, but absorption decreases as hemoglobin levels rise (negative feedback loop).
    • 5-azacytidine and hydroxyurea stimulate fetal hemoglobin (HbF) production, improving sickle cell anemia symptoms.
    • Butyrates prevent the switching from HbF to hemoglobin S (HbS).
    • Agents that stimulate erythropoiesis include erythropoietin (EPO).
    • EPO increases red blood cell (RBC) production and is used to treat anemia.
    • EPO has a role in glial and neuronal cell survival.
    • Darbepoetin alfa is a longer-acting EPO analogue.
    • Agents that stimulate leukocyte production (e.g., filgrastim, sargramostim) are used to increase white blood cell counts.
    • Platelet-producing agents (e.g., rhTPO, eltrombopag, romiplastin, oprevelkin) are used to address low platelet counts.

    Hematopoietic Growth Factors

    • Hematopoietic growth factors stimulate RBC production, helping treat anemia.
    • Erythropoietin (EPO) is used to combat different types of anemia.

    Iron Deficiency Anemia (IDA)

    • IDA occurs when insufficient iron is absorbed, leading to decreased hemoglobin levels.
    • Symptoms of IDA include fatigue, pallor, and cold intolerance.
    • Clinical signs of IDA include microcytic, hypochromic anemia.
    • Diagnosed through serum ferritin, total iron-binding capacity (TIBC), and serum iron (SI) levels.

    Megaloblastic Anemia

    • Megaloblastic anemia results from vitamin B12 or folate deficiency.
    • This impacts DNA synthesis and leads to larger than normal RBCs.
    • Vitamin B12 is essential for methionine and tetrahydrofolate synthesis.
    • Folate is essential for DNA synthesis in the body.

    Studying That Suits You

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

    Quiz Team

    Related Documents

    Pharmacology I: Hematinics & Hematopoietic Drugs PDF

    Description

    Test your knowledge on hematinics and hematopoietic drugs, vital for hemoglobin synthesis and erythrocyte production. This quiz will cover topics such as iron deficiency anemia, dietary sources of iron, and the mechanisms of iron absorption in the body. Brush up on your pharmacology and understand the importance of these crucial nutrients.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser