Arthralgia

Arthralgia: Joint pain

Hydroxyurea

It is used to treat sickle cell disease.

Mechanism of action:
It is found to promote the level of fetal hemoglobin resulting in the dilution of abnormal hemoglobin S (HbS). This may take a long time of up to many months. As a result slow polymerization of HbS occurs and painful conditions are not developed by the sickle cells which are blocking capillaries and causing inadequate supply of oxygen in tissues.

Therapeutic uses:
It is helpful in relieving pain of patients with sickle cell disease.
It is also used to cure chronic type of myelogenous leukemia and polycythemia vera.

Adverse effects:
It may cause suppression of bone marrow and inflammation of the vessels of the skin.

Sargramostim

It is a Hematopoeitic growth factor. It is a granulocyte-macrophage colony stimulating factor (GM-CSF) involved in the increase in granulocyte and macrophages.

Oprelvekin

It is a Hemtopoeitic Growth Factor. It is interleukin-11(IL-11). It is a nonglycosylated protein involved in the increase of platelet count.

Filgrastim

It is an endogenous glycoprotein controlling the production of neutrophils in the bone marrow.

Darbepoetin

It is a Hematopoietic growth factor. Darbepoetin is a longer acting type of erythropoietin which differs from erythropoietin in respect of two additional carbohydrate chains. And because of these two additional chains, its biological activity is increased.

Pharmacokinetics:
Darbepoetin has less value of clearance and have a half life of about three times than that of erythropoietin. It has late start of action and that is why it cannot be used for acute anemia therapy.

Administration:
Sometimes iron is given along with darbepoetin for a better response. Usually subcutaneous route is superior but in the patients undergoing dialysis of kidney it is given intravenously.

Adverse effects:
It may cause hypertension and arthralgia.

Erythropoietin

It is Hematopoeitic Growth Factor. It is a glycoprotein. It is usually made in the kidney.

Recombinant DNA technology is done to obtain human erythropoietin.

Mechanism of action:
It activates the multiplication (proliferation) and development of specialized functions (differentiation) of red blood cells by its interaction with particular erythropoietin receptors on the originators of red cells in the bone marrow.

Therapeutic uses:
It is used for the treatment of patients with end stage renal failure, significant anemic conditions caused by human immunodeficiency virus and anemia in patients of cancer.

Adverse effects:
It may cause hypertension and allergic conditions. Thrombotic complications may also develop. Minimum effective dose must not exceed 12g/dL of hemoglobin concentration. As more than 12g/dL of concentration can cause considerable life threatening effects on the heart and finally can lead to death.