49
Drugs used to
treat anaemias
Learning objectives
Upon completion of this chapter, you should be able to:
1.
Explain the process of erythropoiesis and its correlation with the development of three types of anaemias.
2.
Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most
common adverse reactions and important drug–drug interactions associated with drugs used to treat
anaemias.
3.
Discuss the use of drugs used to treat anaemias across the lifespan.
4.
Compare and contrast the prototype drugs epoetin alfa, ferrous sulfate, folic acid, hydroxocobalamin and
hydroxyurea with other agents in their class.
5.
Outline the considerations, including important teaching points, for people receiving drugs used to treat
anaemias.
Glossary of key terms
anaemia:
disorder involving too few red blood cells (RBCs) or ineffective RBCs that can alter the blood’s ability to carry oxygen
erythrocytes:
RBCs, responsible for carrying oxygen to the tissues and removing carbon dioxide; they have no nucleus and live
approximately 120 days
erythropoiesis:
process of RBC production and life cycle; formed by megaloblastic cells in the bone marrow, using iron, folic acid,
carbohydrates, vitamin B
12
and amino acids; they circulate in the vascular system for about 120 days and then are lysed and recycled
erythropoietin:
glycoprotein produced by the kidneys, released in response to decreased blood flow or oxygen tension in the kidney;
controls the rate of RBC production in the bone marrow
iron-deficiency anaemia:
low RBC count with low iron available because of high demand, poor diet or poor absorption; treated with
iron replacement
megaloblastic anaemia:
anaemia caused by lack of vitamin B
12
and/or folic acid, in which RBCs are fewer in number and have a weak
stroma and a short lifespan; treated by replacement of folic acid and vitamin B
12
pernicious anaemia:
type of megaloblastic anaemia characterised by lack of vitamin B
12
secondary to low production of intrinsic
factor by gastric cells; vitamin B
12
must be replaced by intramuscular injection or nasal spray because it cannot be absorbed through
the gastrointestinal tract
plasma:
the liquid part of the blood; consists mostly of water and plasma proteins, glucose and electrolytes
reticulocyte:
RBC that has lost its nucleus and entered circulation just recently, not yet fully matured
Test your current knowledge of drugs used to treat anaemias with a PrepU Practice Quiz!
Simulation-based learning
On completion of the chapter, consider the scenario of Lloyd Bennett (Part 1) who has been ordered a blood transfusion
for low haemoglobin post-operatively. Consider whether medication management, and if so, which products may also
assist in raising his haemoglobin levels.
