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Various drugs may cause anemia via an effect on the renin-angiotensin-aldosterone system (RAAS). The
renin-angiotensin-aldosterone system is an important factor affecting hematopoiesis. RAAS regulates
erythropoiesis via two mechanisms: Angiotensin II acts as a growth factor for erythroid progenitors in
the bone marrow. Second, Angiotensin II stimulates erythropoietin secretion.[67] Activation of RAAS may
explain the development of secondary erythrocytosis in patients with COPD and chronic hypoxemia.[67]
Alteration in the activation of RAAS via ACE inhibitors and AT1 receptor blockers may explain anemia in
COPD patients.[68,69] Theophylline also has the potential to affect erythrocytosis in patients with COPD.
One mechanism is modulation of EPO production via adenosine receptor A2 antagonism.[70] Tsantes et
al., however, did not find support for this hypothesis. They reported significantly lower hemoglobin
levels in COPD patients treated with theophylline than those not on theophylline (P < 0.05). Serum EPO
levels did not differ between the studied groups. They proposed a direct inhibitory action of theophylline
on erythropoiesis, possibly via enhanced apoptosis.[71]

Erythropoiesis in COPD can be affected by various factors and it can manifest by either anemia or
polycythemia.

- Atropine 0.4 mg with Demerol 50 mg I.M. on call to OR

- Nembutal 25 mg I.M. PTOR (prior to OR)
- Celecoxib 200 mg/cap 1 cap twice a day for 3 days for
pain
- Cefazolin 1g IVTT ANST 1 hour PTOR
- Omeprazole 40 mg/cap 1 cap at hours of sleep
- Etoricoxib 120 mg/tab 1 tab 1 hour prior to OR
Results of the experiment show that, thanks to joyful lectures, students are not only happier, but they
also remember more information, even if topics relate to purely business problems. Despite the fact
that in the case of accounting the results of the experiment are not so clear, in the case of
management classes students evaluated funny classes as better than traditional ones. They also
remembered more information. That's why we can put forward a thesis that one of barriers to
learning is rigid and serious way of teaching.