Brand/Generic
Alternative name for B12
Recommended daily amount of folate
How much is 400mcg/d?
Recommended daily Vitamin B12
How much is 2.4-2.6mcg/d?
Define ESA
What is an erythropoeitin stimulating agent
Level of B12 at which you should worry
How much is <200pg/mL?
Alternative name for folate
What is vitamin B9?
Tongue symptoms of this anemia
What is a smooth and tender tongue?
Tongue symptom of this anemia
What is a red and beefy tongue with tingling, numbness, or glossodynia?
BBW for ESA's
What is an increase risk of cancer and MACE?
The level of folic acid in anemia
How much is <4ng/mL?
Three ESA treatments for inflammation anemia
What are epoetin-alfa (Epogen, Procrit), darbepoetin alfa (Aranesp), and methyl polyethylene glycol-epoetin beta (Mircera)?
When and how to treat this anemia
What are dietary, PO, and IV folate? Treat with 1-5mg/d, eat more animal organs, vegetables, fruits, legumes, and fortified food.
When to use IV, nasal spray or PO treatments
What are neurological symptoms, maintenance after IM, and first-line therapy?
Infusion of whole blood risks
What are TRALI, TACO, infeciton, hypercalemia, volume overlaod, iron overlaod, and allergic and immune transfusion reactions?
TRALI: transfusion-related acute lung injury
TACO: transfusion associated cardiac overlaod
Normal homocysteine levels
How much is <13mcmol/L?
Only ESA not approved for cancer treatment
What is methoxy polyethylene glycol-epoeitin beta?
Brand name Mercera.
Response of folate therapy
How long is reticulocytosis within 2-3 days, HGB begins to rise after 2 wks, and normalizes within 2-4 months, and long term treatment may be necessary in chronic diseases?
Causes of Vitamin B12 anemia
What are metformin, pernicious anemia, GI surgery, poor diet, or inadequate utilization of B12 stores?
Explain monitoring for ESA in CKD and cancer
What is monitoring HGB weekly then monthly?
Increase dose by 25% every 4 weeks if HGB does not increase by 1g/dL after 4 weeks.
Decrease dose by 25% if HGB increases by >1g/dL in 2 weeks.
Discontinue if HGB >11g/dL or after 12 weeks.
Therapeutic goal level for ESA agents
How much is 8-10g/dL?
The ESA approved with zidovudine for HIV dosing anemia
What is epoetin alfa?
Causes of folate deficiency
What are alcohol use disorder, pregnancy, poor diet, fad diets, increased demand of folate, and specific drugs; Azathioprine, 5-FU, hydroxyurea, zidovudine, 6-MP, methotrexate, trimethoprim, pentamidine, triamterene, barbiturates, phenytoin, and primidone.
Side effects from B12 supplementation
What are hyperuricemia and hypokalemia?
Explain the monitoring for ESA in cancer
What is weekly during initiation and dose adjustments, then monthly for maintenance?
Increase the dose to 4.5mcg/kg x 1 week if HGB does not increase by 1g/dL after 6 weeks.
Decrease dose by 40% if HGB increases by more than 1g/dL in 2 weeks.
Discontinue if no more chemo, after 8 weeks of no HGB response, or RBC trasnfusions still required.
Differentiation of anemia of inflammation
What are...
MCV and TIBC can be normal or reduced
Ferritin can be normal or increased
Erythropoietin is usually reduced