7 topics with concise reviews: definitions, key facts, and class questions.
This section is dedicated to drugs that manage blood cell formation and maintain its fluid state. Here we thoroughly analyze erythropoiesis stimulants (iron preparations, cyanocobalamin, folic acid, erythropoietins), leukopoiesis-activating agents, as well as cytostatics and other drugs that suppress excessive hematopoiesis. The pharmacology of hemostasis is covered in a separate comprehensive block.
Pharmacotherapy of anemias is traditionally strictly questioned in classes and exams. You will be required to have a clear understanding of: in which cases iron preparations are prescribed, when vitamin B12 or folic acid is necessary, and what the fatal danger of their incorrect use is. Another favorite question of instructors is the sites of action and mechanisms of action of agents affecting hemostasis, since adequate therapy of bleeding and thrombosis is impossible without this knowledge.
Why is it better to wash down iron preparations with water rather than tea?
Tea contains tannin, which is a potent absorption antagonist. It forms poorly soluble complexes with iron ions, blocking their absorption in the gastrointestinal tract.
Where in the body is the bulk of endogenous erythropoietin synthesized?
The main source (90%) is peritubular cells of the kidneys, with another 10% produced by liver cells.
Why do erythrocytes become abnormally large (megaloblasts) in B12 deficiency?
Due to vitamin deficiency, DNA synthesis necessary for cell division is impaired. The bone marrow cell (erythroblast) grows, accumulates hemoglobin, but cannot divide, turning into a giant megaloblast.
Why must folic acid not be prescribed separately from vitamin B12 in pernicious anemia?
Isolated administration normalizes blood counts but does not eliminate neurological disorders, leading to their latent progression.
Can vitamins B12 and folic acid be used to stimulate leukopoiesis?
Cyanocobalamin and folic acid are necessary for DNA synthesis in rapidly dividing bone marrow cells and can be used as adjunctive agents. However, they are not specific leukopoiesis stimulants.
What disease is the main indication for prescribing radioactive phosphorus?
The drug is used for polycythemia vera (erythremia). This pathology involves uncontrolled proliferation of blood cells, especially erythrocytes, which must be suppressed.
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