anaemia Flashcards
indications for iron
Rx and prophylaxis of IDA.
MOA iron
iron absorbed in duodenum in fe2+ state. better absorbed by acid. bound to transferrin.
SE iron
= GI upset - nauseam epigastric pain, constipation, diarrhoea
- bowels turn black
- IV iron = injetion site irritation and hypersensitivity reaction including anaphylaxis
who should you give iron cautiously too
- Those with intestinal disease e.g. IBD, diverticular etc.
IV iron - careful in atopic predisposition
interactions of iron
oral iron can reduce absorption of levothyroxine and bisphosphonates. these medications should be taken 2hrs before oral iron
dose of iron
- in IDA need to give 100-200mg of elemental iron per day. in 200mg ferrous sulfate there is 65mg elemental. so give two to three times a day.
in prophylaxis - 200mg ferrous suphate.
when to take iron
- best before food but due to GI SE with food is fine.
IV - injection over 10mins or infusion.
how much of a hb rise should you see per month if appropriately treating IDA with iron
20g/L/month
before what procedure should ironn be stopped and whn
- colonoscopy as turns stools black by coating colon. stop 7 days before.
what is thiamine - vitb1s indication
rx and prevent wenickes and korsakoffs
indication fo folic acid - vit b9
megaloblastic anaemia and
1st trimester pregnancy those at risk of NTDs
indication for hydroxyocobalamin - vit b12
megaloblastic anaemia and subacute degeneration of cord
indication for phytomenadione - vit k
- all newborns to prevent deficiency bleeding
- anticoag warf reversal
what vitamins are most likely to give anaphylaxis if given IV
- Phytomenadione = vit k
- high dose thiamine
in patients with vit b12 and folate deficiency, which do you replace first?
do simultaneously. if only replace folate - neuro symptoms of b12 deficiency. and rpvoke subacute degeneration of cord.
