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4 Cards in this Set
- Front
- Back
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Iron
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- Stored in intestinal mucosal cells as ferritin
- iron def results from a negative iron balance due to depletion of iron stores and/or inadequate intake, culminating in hypochromic microcytic anemia - Supplementation w. ferrous sulfate required to correct deficiency - GI disturbances caused by local irritation = most common AE |
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Folic Acid
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- caused by increased demand (preg, lactation), poor absorption, alcoholism, and tx w/ drugs that are dihydrofolate reductase inhibitors (ex methotrexate and trimethoprim)
- primary result of def = megaloblastic anemia caused by diminished syn of purines and pyrimidines - folic acid is absorbed in the jejunum - no known toxicity |
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Cyanocobalamin (Vit B12)
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- due to poor absorption of the vit due to the faiulre of gastric parietal cells to produce intrinsic factor (ex pernicious anemia) which is needed for absorption
- vitamin admin orally (dietary def), IM, or deep subcutaneously (pernicious anemia) - def can lead to severe neurological dysfunction and disease - no known adverse effects |
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EPO and Darbepoetin
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- EPO normally made by kidney
- regulates RBC proliferation and diff in BM - EPO used in end-stage renal disease, anemia assoc w/ HIV, anemia in cancer - Darbepoetin = long-acting version of EPO (has 2 extra carbohydrate chains) - Darbepoetin has decreased clearance, 3x the half life of EPO, but no value in acute tx - EPO/Darb given IV in renal dialysis pts but preferred route = subcutaneous - AE = inc BP and arthralgia - Recc = minimum effective dose shouldnt exceed Hb level of 12g/dL and should not rise more than 1g/dL over a 2wk period |
