DOC PREVIEW
UIC PCOL 425 - Sickle Cell Anemia

This preview shows page 1-2-15-16-31-32 out of 32 pages.

Save
View full document
View full document
Premium Document
Do you want full access? Go Premium and unlock all 32 pages.
Access to all documents
Download any document
Ad free experience
View full document
Premium Document
Do you want full access? Go Premium and unlock all 32 pages.
Access to all documents
Download any document
Ad free experience
View full document
Premium Document
Do you want full access? Go Premium and unlock all 32 pages.
Access to all documents
Download any document
Ad free experience
View full document
Premium Document
Do you want full access? Go Premium and unlock all 32 pages.
Access to all documents
Download any document
Ad free experience
View full document
Premium Document
Do you want full access? Go Premium and unlock all 32 pages.
Access to all documents
Download any document
Ad free experience
View full document
Premium Document
Do you want full access? Go Premium and unlock all 32 pages.
Access to all documents
Download any document
Ad free experience
Premium Document
Do you want full access? Go Premium and unlock all 32 pages.
Access to all documents
Download any document
Ad free experience

Unformatted text preview:

Sickle Cell Anemia Hemoglobin HbA adult 2 2 HbF fetal 2 2 Sickle Cell Hemoglobin a single E6V mutation in the chain HbA adult 2 2s Normal vs Sickled Erythrocytes DeoxyHb Fibers in Sickle Erythrocyte Inter molecular Contacts of HbS fibers Defects of Sickled Erythrocytes More rigid and adhesive lodged in microvasculatures resulting in vascular occlusion Microinfarction kidney impaired its ability to concentrate urine and produce erythropoietin Altered ability to activate complement and defective granulocyte function infections Splenic sequestration of sickled erythrocytes results in hemolytic anemia and splenomegaly Treatments of Sickle Cell Disease Gene therapy Prevention of infections penicillin in children Supportive managements of vaso occlusive crises pain killers chronic heparin therapy Hydroxyurea increases HbF levels to 15 20 reducing frequency of vaso occlusive crises Prophylactic use not for treatments of crises Cytotoxic side effects include GI effects nausea vomiting diarrhea dermatologic effect macular papular rash pruritus and risk of secondary neoplasm leukemia with prolonged use Hydroxyurea Erythropoietin therapy REVIEW Anemia Anemia Caused by impaired rbc production Hypochromic anemia Megaloblastic anemia Aplastic anemia Sickle Cell anemia Hypochromic Anemia Microcytic rbc Iron deficiency Absorption duodenum and jejunuum transported in blood by transferrin heme iron non heme iron ferrous salts ferric salts Cause dietary insufficiency blood loss interference of iron absorption Treatments oral therapy ferrous sulphate administered under fasting parenteral therapy iron dextran injection im or iv Megaloblastic Anemia Macrocytic rbc Vitamin B12 or folate deficiency Interrelationship of vitamin B12 and folate metabolism methyltetrahydrofolate donates its methyl group to vitamin B12 active metabolite N5 10 methylene tetrahydrofolate supports the conversion of dTMP to dUMP necessary for DNA synthesis Vitamin B12 deficiency Absorption released from food and bound to Intrinsic Factor absorbed through the mucosa of ileum transferred by transcobalamin II in blood uptake by liver or target cells Cause dietary insufficiency deficiency of Intrinsic Factor Addisonian pernicious anemia damage to ileal mucosa deficiency of transcobalamin II rare Treatments oral therapy to supplement deficient diet cyanocobalamin injection im or sc for absorption problems Folate deficiency Absorption Reduced and methylated absorbed through the mucosa of duodenum and jejunum transported in blood to liver or target cells enterohepatic cycle of folate for reabsorption Cause dietary insufficiency malnutrition and alcoholism damage to small intestine Treatments oral preparations Folic acid injection for absorption problems Aplastic Anemia Caused by disturbed stem cell kinetics Erythropoietin growth factor to stimulate rbc production produced primarily by the kidney recombinant erythropoietin for treatment of anemia in anephric patients administered parenterally Myeloid Growth Factors GM CSF granulocyte macrophage colony stimulating factor G CSF granulocyte colony stimulating factor Recombinant forms for treatment of neutropenia Sickle Cell Anemia Cause E6V mutation in the Hb chain Treatments Hydroxyurea increase the expression of HbF 2 2 REVIEW Anti thrombotic Drugs Hemostasis and Thrombosis Blood Coagulation Platelet aggregation Therapy of thrombosis Anticoagulants Anti platelet drugs Plasminogen activators Anticoagulants and anti platelet drugs for the prevention of the formation of thrombi Plasminogen activators for lysis of existing thrombi Heparin Mechanism of action negatively charged sugar subunits binds to lysine residues of anti thrombin III to activate it neutralizes thrombin and other clotting factors Absorption highly charged administered parenterally crosses membranes poorly drug of choice for pregnant women Complications hemorrhage heparin induced thrombocytopenia Coumarins Warfarin Oral anticoagulants Mechanism of action Vitamin K cycles between the KO and KH2 forms Vitamin KH2 is required for the conversion of Glu to Gla in some clotting factors Warfarin blocks the reduction of vitamin KO to vitamin KH 2 Absorption Given orally 99 is albumin free in plasma only the free form is active crosses the placenta cannot be used during pregnancy Complications hemorrhage drug interactions Anti platelet drugs Aspirin Dipyridamole ADP receptor antagonists Clopidogrel and Ticlopidine GPIIb IIIa or fibrinogen receptor antagonists Abciximab Eptifibatide and Tirofiban Aspirin Mechanism of action In activated platelets arachidonic acid is released and metabolized by cyclooxygenase to the potent platelet agonists PGH2 and TXA2 Aspirin acetylates cyclooxygenase rendering it inactive Complications Gastrointestinal bleeding It also inhibits cyclooxygenase on endothelial cells to block the formation of PGI2 a natural platelet inhibitor Recommended Uses Low doses Dipyridamole Mechanism of action An increase in cAMP in platelets inhibits platelet function by sequestering calcium into its platelet storage sites Dipyridamole inhibits cAMP phosphodiesterases and increases platelet cAMP by preventing its breakdown Complications Non specific and not effective Recommended Uses In combination with warfarin to prevent thromboembolism in patients with artificial heart valves ADP Receptor Antagonists Clopidogel and Ticlopidine Mechanism of action Blocks the P2Y12 an ADP receptor on platelets Complications Nausea dyspepsia diarrhea hemorrhage leukopenia anemia Recommended Uses In combination with low dose aspirin In aspirin intolerant and aspirin resistant patients GPIIb IIIa Antagonists Abciximab Eptifibatide Tirofiban Mechanism of action Blocks fibrinogen binding to GPIIb IIIa thereby inhibiting platelet aggregation Complications Oral drugs not active Recommended Uses Administered parenterally Plasminogen Activator t PA Urokinase Streptokinase Fibrinolysis plasminogen is converted to plasmin which degrades fibrin clots Tissue type plasminogen activator t PA serine protease synthesized by endothelial cells fibrin specific Urokinase zymogen synthesized by kidney cells fibrin specific Streptokinase produced by hemolytic streptococci complexed with plasminogen to change its conformation NOT fibrin specific degrades both fibrinogen and fibrin REVIEW Anti atherosclerotic Drugs Atherosclerosis LDL in blood penetrates into the subendothelium and becomes oxidized Oxidized LDL induces transmigration of monocytes and macrophages


View Full Document

UIC PCOL 425 - Sickle Cell Anemia

Documents in this Course
Exam 3

Exam 3

7 pages

Kozasa

Kozasa

14 pages

Load more
Download Sickle Cell Anemia
Our administrator received your request to download this document. We will send you the file to your email shortly.
Loading Unlocking...
Login

Join to view Sickle Cell Anemia and access 3M+ class-specific study document.

or
We will never post anything without your permission.
Don't have an account?
Sign Up

Join to view Sickle Cell Anemia 2 2 and access 3M+ class-specific study document.

or

By creating an account you agree to our Privacy Policy and Terms Of Use

Already a member?