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INTRODUCTION

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This chapter will be most useful after having a basic understanding of the material in Chapter 37, Hematopoietic Agents: Growth Factors, Minerals, and Vitamins in Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. In addition to the material presented here, the 12th Edition contains:

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  • A description of hematopoietic cell growth and differentiation and the role of hematopoietic growth factors in these processes

  • A discussion of iron metabolism and storage in the body

  • A discussion of factors that cause iron deficiency anemia

  • A discussion of vitamin deficiencies that can lead to anemia

  • Table 37-3 Iron Requirements for Pregnancy

  • Table 37-2 The Body Content of Iron

  • Table 37-5 Average Response to Oral Iron

  • The molecular structures of vitamin B12 and folic acid, and their congeners

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LEARNING OBJECTIVES

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  • Understand the mechanisms of action of drugs, minerals, and vitamins used to stimulate hematopoiesis.

  • Know the untoward effects of drugs used to stimulate hematopoiesis.

  • Know the clinical application of hematopoietic growth factors and how efficacy of therapy is monitored.

  • Know how mineral and vitamin deficiencies can lead to specific anemia, how these are diagnosed, and how they are treated with individual agents or combinations of agents.

  • Know when iron and vitamin supplementation should be used prophylactically.

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DRUGS INCLUDED IN THIS CHAPTER

  • Copper sulfate (cupric sulfate)

  • Cyanocobalamin (vitamin B12; CALOMIST, NASCOBAL)

  • Darbepoetin alfa (ARANESP)

  • Eltrombopag (PROMACTA)

  • Epoetin alfa (recombinant erythropoietin; EPOGEN, PROCRIT, EPREX)

  • Ferrous fumarate (HEMCYTE, FEOSTAT, others)

  • Ferrous gluconate (FERGON, others)

  • Ferrous succinate, aspartate, and other ferrous salts

  • Ferrous sulfate (FEOSOL, others)

  • Ferumoxytol (FERAHEME)

  • Folic acid (pteroylglutamic acid [PteGlu], l-methylfolate)

  • Folinic acid (leucovorin calcium, citrovorum factor)

  • G-CSF (recombinant G-CSF, filgrastim; NEUPOGEN)

  • GM-CSF (recombinant GM-CSF, sargramostim; LEUKINE)

  • Hydroxocobalamin (vitamin B12)

  • IL-11 (recombinant IL-11; oprelvekin; [NEUMEGA]

  • Iron dextran (DEXFERRUM, INFED, IMFERON)

  • Iron sucrose (VENOFER)

  • Pegylated recombinant G-CSF (pegfilgrastim; NEULASTA)

  • Polysaccharide-ferrihydrite complex (NIFEREX, others)

  • Pyridoxine

  • Riboflavin

  • Romiplostim (NPLATE)

  • Sodium ferric gluconate (FERRLECIT)

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Table Graphic Jump Location
MECHANISMS OF ACTION OF HEMATOPOIETIC AGENTS

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