A.

( Hbs )

Hydroxyurea
(Hydroxycarbamide)

HbF
production
abberated Hbs

reticulocyte
myelosuppresionneutropenia,
GI effects, teratogenicity for

antineoplastic
agent, RBC

B. microcytic hypochromatic
1.Fe2+ ferrous

Ferrous sulfate hydrated

Ferrous sulfate dessicated
Ferrous gluconate
Ferrous fumarate

325mg,65mg Fe/
200mg,65mg Fe/
325mg,36mg Fe/
325mg,106mg Fe/

Iron dextran (50mg Fe/mL)

1.InFeD ()
2.DexFerrum ()
Sodium ferric gluconate complex
Sodium sucrose complex

1.
()
2.black stool

2.Fe- colloid

1.IV common
athralgias (
2. deep IM
)urticaria (
)
IV

1.Daily dosage 200-400mg, 3

6
2./

DexFerrum
anaphylaxis

C. Iron toxicity

Deferoxamine
Whole bowel irrigation
Intermittent
phlebotomy
Deferasirox

Fe chelator, bind to Fe

300mL

IV

iron toxicity
iron toxicity
iron toxicity

Fe chelator, deferoxamine

oral

Deferiprone

D. B12 (megaloblastic, macrocytic)

Folic acid

B12
DNA synthesis

Hydroxocobalamin
Cyanocobalamin

active form of
cobalamin

folic acid dihydrofolate

H4folate DNA methyl
transfer cofactors
Hydroxocobalamin preferred
bound to protein

Oral

IM
100-1000mcg QD or QOD
6

E. folic acid (megaloblastic)

1mcg/day

Folic acid

EPO Erythropoietin RBC

Epoetin alfa
Darbepoetin alfa
Methoxy polyethylene
glycol-epoetin beta

hemocrit,
hemoglobin
reticulocyte
count

IV,1 3 t1/2 =4-13hrs

IV,1 1 , t1/2 =12-39hrs
IV SC 1 ,
t1/2 =130hrs

thrombotic
Faster tumor growth

PRCA

1.
2.endo
EPO <100IU/L
3.AIDS zidovudine

Myeloid Growth Factors ( WBC neutrophils)

rHuG-CSF
Filgrastim
Pegfilgrastim

neutrophils
neutrophils
neutrophils
filgrastim covalent
conjugation polyethylene glycol

IV SC
Filgrastim,
Pegfilgrastim
cycle

1.
neutropenia
2.AML
3. cyclic
neutropenia

Lenograstim
rHuGM- CSF
Sargramostim
Plerixafor

form
gylcosylated G-CSF,

neutrophils efficacious
G-CSF
effect

4.PBSC
filgrastim

malaisearthralgias
myalgias
SC, G-CSF 4
1. anti-HIV drugs by
targeting CXCR4
leukapheresis 11
2.

Megakaryocytes Growth Factors

IL-11

Oprelvekin
Romiplostim
(AMG 531)

Eltrombopag

rIL-11, E.Coli
7-8hrs
Mp1 bind
to TPOR

TPOR

Fatigue

dyspnea

non-myeloid cancer

SC, 3-4
at day
5,day10-12 peak

Mild headache

Oral

1. chronic idiopathic
thrombocytopenia(ITP)
2. thrombocytopenia

first-line treatment

SC

HMG-CoA reductase inhibitors () (LDL-C)


Lovastatin
Simvastatin
Pravastatin
Fluvastatin
Atorvastatin
Rosuvastatin
Pitavastatin

:active form HMG-CoA intermediate analogs,

isoprenoids LDL catabolism LDL uptake

Inactive lactone
<80mg/day1-3hrs
1.Atorva,lova simva 1. LDL-C
rings GI 5-80mg/day;1-3hrs
CYP3A4
2.
-hydroxyl
2.Fluva,rosuva pitava

10-80mg/day;1-3hrs
Active lactone ring
CYP2C9
3. niacin, fibrate
10-80mg/day;1-3hrs
Active fluorine3.Prava sulfation
ezetimibe LDL-C
10-80mg/day;14hrs
containing
4. atorva rosuva
4.,
5-40mg/day,
evening if
5.
19hrs
QD

1-4mg/day;12hrs
5. prava 6. CK
statin
prava

7. verapamil/
6. gylcosylation, amiodarone CYP3A4
gemfibrozil
myopathy

risk

Niacin (VitB3)nicotinic acid (VLDL-TG)

Niacin
Crystallized
Niacin

lipase VLDL LDL

VLDL TG

Resin/statin
2-6g/day
Heterozygous familial 1.

aspirin/ibuprofen

2.tachyphylaxis flushing
100mg/bid tid

3.
1.5-3.5mg/day

4.
5. insulin resistance
6. hyperuricemia,
allopurinol
7. potency,
hypotension

Fibric Acid Derivatives(Fibrates)(VLDL-TG)

Gemfibrozil

Fenofibrate

Bezafibrate
Clofibrate

Targeting on PPAR-, FFA lipolysis in

lipolysis VLDL TG serum

600mg/QD or BID 1. with 1. statin

fenofibrate
1.5hrs;

VLDL
2./

2.
3. gallstone risk
caused by viral
Isopropyl ester;
1-3 48mg (
biliary tract
protease
100% 145mg/day)
4. coumarin
20
60%urine;20%feces
indanedione potency
available

Bile Acid-binding Resins (BARs) (LDL-C)

Colestipol
Cholestyramine

: bind to bile acid excreted conversion

Of cholesterol bile acid in LDL; LDLR in
LDL uptake from plasma

1.granular 4-5g/day 1. 1.
20g/day;max 30-32g/day; VLDL,

10-20g/day

2. diverticulitis
niacin
2.colestipol 1g tablet;
3.

Colesevalem

maximum 16g/day;
625mg tab or suspension in
1875 3750mg packets
6 tablets or 3750mg max

2. bind to

digitalis toxicity
3.colesevalem
bind to digitoxin,
warfarin statin

homozygous
4.

5. niacin
BARs 1-2hrs

Inhibitors of Intestinal Sterol Absorption (LDL)

Ezetimibe

Targeting on NPC1L1, phytosterol

1.Hypercholesterolemia
5-20mg/day;
1. impairment myolitis

2.
statin

2. when used with

10mg/day
activated glucoronide

10%
25%
fibrates; when used
80%
with cholestyramine

CETP inhibitors (HDL,LDL)

Targeting on CETP, HDL LDL

Torcetrapib
Dalcetrapib
Evacetrapib
Anacetrapib

desired efficacy

clinical trial cardiovascular events death

clinical trial

PCSK9 inhibitors (LDL)

inactivate PCSK9 LDLR LDLR
LDL

AlirocumabEvolocumab

Combinative Therapy of Dyslipidemia

Statins + BARs
BARs + Niacin
Statins + Niacin

LDL
VLDL

LDL VLDL
heterozygous familial hypercholesterolemia, both

hypercholesterolemia homozygous

Statins + Azetimibe
Statins (Rosuvastatin) + Fenofibrate
Fibrate + BARs
BARs + Ezetimibe + Niacin + Statins

LDL
both VLDL LDL
familial dyslipidemia intolerant to niacin/statins
cholelithiasis
efficient combinative therapy
constant monitoring

1. statins 105-2
A. HMG-CoA reductase
B. niacin
C.
D. LDL
2.105-2
A.Gemfibrozil
B.Ezetimibe
C.Nicotinic acid
D.Colesevelam
3. cholestyramine 105-2
A.
B.
C.styrene
D.
4.105-1
A.atorvastatin
B.cholestryramine
C.ezetimibe
D.niacin
5. Sargramostim 104-2
A.

B.
C.
D.
6. Niacin (104-1)
A.Anisindione
B.Ibuprofen
C.Chlordiazepoxide
D.Conivaptan
7. HMG-CoA (104-1)
A.Lovastatin
B.Pravastatin
C.Atorvastatin

D.Fluvastatin

8. isopropyl ester(103-2)
A.Fenofibrate
B.Ezetimibe
C.Atorvastatin
D.Cholestyramine
9. Ezetimibe (103-1)
A.-alphaPPAR-
B.
C.
D. LDL
10. hemochromatosis(102-2)
A.
B. cyanocobalamin
C. deferasirox
D.
11. Oprelvekin (102-1)

A. G-CSF
B. IL-11
C.Erythropoietin
D. heme

12. statins (102-1)

A.Rosuvastatin
B.
C. fibrates myopathy
D. barbiturates
13. fondaparinux 102-1
A.Sulfonated tetrasaccharide
B.Sulfonated pentasaccharide
C.Sulfonated hexasaccharide
D.Sulfonated heptasaccharide
14. B12
(101-2)
A. B12 intrinsic factor
B. B12 tetrahydrofolate
C. B12 megaloblastic anemia
D. B12 B12
15. Niacin (101-1)
A.
C.
B.
D.

16. Cerivastatin 5(101-1)

A.colestipol
B.ezetimibe
C.gemfibrozil
D.niacin
17. Lovastatin (101-1)
A. 4
B. lactone dihydroxy acid HMG CoA reductase
C.bile acid
D. lipoprotein lipase
18.Atorvastatin CYP3A4(100-2)
A.Atorvastatin
B. Atorvastatin
C.Atorvastatin
D.
19. statin prodrug(100-2)
A.Atorvastatin
B.Fluvastatin
C.Pravastatin
D.Simvastatin
20. (100-1)
A.Erythropoietin
B.Filgrastim

C.Oprelvekin

D.Vitamin B12