NURS 5433 Anemia Exam Study Guide
Drugs Used for Anemia
1. Define anemia
Decrease in size, number or hemoglobin
2. What are the most common causes of anemia?
Blood loss, BM problems, hemolysis
3. Differentiate microcytic, macrocytic, hypochromic, normochromic; how do
these relate to cell morphology?
Microcytic: small size : MCV
Macrocytic: bigger size : MCV
Hypochromic: low color: MCHC
Normochromic: normal color: normal MCHC
4. Identify dietary sources of iron, folic acid, and vitamin B12.
Source for iron: Liver, egg yolk, brewers yeast, wheat gram, fish, fowl, red
meat, grains, cereal, beans and green leafy vegetables
Sources for Vitamin B12: liver, dairy, fortified foods
Sources for Folic acid: all food
5. Discuss the advantages and disadvantages of the various iron compounds.
Dextran Ferric gluconate complex Surcose
Intolerance to PO IDA +/- CKD; dialysis pt CKD+ IDA
WITH erythropoietin
ADE: anaphylaxis; h/a, Transient flushing, Hypotension, cramps,
hypotension, fever, hypotension, HF, sepsis, taste
urticaria, fever, lightheadedness, perversion
arthralgias, persistent malaise, fatigue,
pain with IM inj. weakness, severe pain
in chest, back, flank and
groins,
Fe Fumarate: less GI ADE
Carbonyl Fe: powdered or chewable Fe. Less toxic less ADE.
, PO ADE: GI disturbance; staining of teeth with liquid; N/V; CONSTIPATION
TOXICITY: diarrhea, shock followed by acidosis, gastric necrosis, liver failure,
PE, vasomotor collapse: therefore, never part of multivitamin
6. Identify substances that reduce iron absorption.
Increased acid increase absorption. PPI, Tetracycline: decrease
absorption Ascorbic acid: increase absorption
7. What is the relationship between B12 deficiency and Folic Acid deficiency?
A deficiency in vitamin B12 leads to a functional deficiency of folate.
Specifically, when
there is insufficient vitamin B12, the enzyme methionine synthetase
becomes less active.
This enzyme is crucial for converting homocysteine to
methionine using 5-
methyltetrahydrofolate (the active form of folate) as a
substrate.
8. What is an “intrinsic factor”?
Glycoprotein secreted by parietal cells in the gastric lining responsible for
absorption of Vit B12 in small intestine esp. in distal ileum.
9. Discuss the monitoring of pharmacology treatment effectiveness for the
different anemias. For iron deficiency anemia: recheck Hgb in 30 days of PO
treatment: if increase in 1gram/dL: treatment successful.
For Vit B12: check MMA in urine / blood +/- homocysteine: increased: B12
deficiency For sickle cell: hemolysis and leukocyte count fell; Hbg conc.
Increased.; HgB F increased from 5-9% and in top responders: up to 18% inc.
in Hbg F.
10.Discuss the mechanism of action, side effects/adverse effects,
contraindications, and drug interactions for the drugs used to treat anemia.
Drug MOA ADE Monitoring D/D
interaction
Drugs Used for Anemia
1. Define anemia
Decrease in size, number or hemoglobin
2. What are the most common causes of anemia?
Blood loss, BM problems, hemolysis
3. Differentiate microcytic, macrocytic, hypochromic, normochromic; how do
these relate to cell morphology?
Microcytic: small size : MCV
Macrocytic: bigger size : MCV
Hypochromic: low color: MCHC
Normochromic: normal color: normal MCHC
4. Identify dietary sources of iron, folic acid, and vitamin B12.
Source for iron: Liver, egg yolk, brewers yeast, wheat gram, fish, fowl, red
meat, grains, cereal, beans and green leafy vegetables
Sources for Vitamin B12: liver, dairy, fortified foods
Sources for Folic acid: all food
5. Discuss the advantages and disadvantages of the various iron compounds.
Dextran Ferric gluconate complex Surcose
Intolerance to PO IDA +/- CKD; dialysis pt CKD+ IDA
WITH erythropoietin
ADE: anaphylaxis; h/a, Transient flushing, Hypotension, cramps,
hypotension, fever, hypotension, HF, sepsis, taste
urticaria, fever, lightheadedness, perversion
arthralgias, persistent malaise, fatigue,
pain with IM inj. weakness, severe pain
in chest, back, flank and
groins,
Fe Fumarate: less GI ADE
Carbonyl Fe: powdered or chewable Fe. Less toxic less ADE.
, PO ADE: GI disturbance; staining of teeth with liquid; N/V; CONSTIPATION
TOXICITY: diarrhea, shock followed by acidosis, gastric necrosis, liver failure,
PE, vasomotor collapse: therefore, never part of multivitamin
6. Identify substances that reduce iron absorption.
Increased acid increase absorption. PPI, Tetracycline: decrease
absorption Ascorbic acid: increase absorption
7. What is the relationship between B12 deficiency and Folic Acid deficiency?
A deficiency in vitamin B12 leads to a functional deficiency of folate.
Specifically, when
there is insufficient vitamin B12, the enzyme methionine synthetase
becomes less active.
This enzyme is crucial for converting homocysteine to
methionine using 5-
methyltetrahydrofolate (the active form of folate) as a
substrate.
8. What is an “intrinsic factor”?
Glycoprotein secreted by parietal cells in the gastric lining responsible for
absorption of Vit B12 in small intestine esp. in distal ileum.
9. Discuss the monitoring of pharmacology treatment effectiveness for the
different anemias. For iron deficiency anemia: recheck Hgb in 30 days of PO
treatment: if increase in 1gram/dL: treatment successful.
For Vit B12: check MMA in urine / blood +/- homocysteine: increased: B12
deficiency For sickle cell: hemolysis and leukocyte count fell; Hbg conc.
Increased.; HgB F increased from 5-9% and in top responders: up to 18% inc.
in Hbg F.
10.Discuss the mechanism of action, side effects/adverse effects,
contraindications, and drug interactions for the drugs used to treat anemia.
Drug MOA ADE Monitoring D/D
interaction
