Anaemias Flashcards
WHAT IS MEANT BY SICKLE CELL ANAEMIA
Deformed less flexible red blood cells
- acute complications- sickle cell crisis- restricted blood supply to organs
-hospitalisation- fluid replacement, analgesia, treat any infection
- complications associated: anaemia, leg ulcers, renal failure, susceptible to infections
If patient has haemolytic anaemia (the breakdown of red blood cells) : increase folate (folic acid supplementation)
Hydroxycarbamide reduces frequency of painful crisis and reduces transfusion requirement
What is meant by G6PD deficiency
Common in Africa and Asia - more common in males than females
Susceptible in developing acute haemolytic anaemia
Drugs with definite risk of hameolysis in most G6PD deficient individuals
- dapsone and other sulfones, fluoroquinolones, nitrofurantoin, quinolones
Drugs with possible risk of hameolysis in some G6PD deficient individuals
-aspirin, chloroquine, menadione, quinine and sulfonylureas
What is meant by iron deficiency
Must be able to show iron deficiency to treat with iron preparation
Excludes serious underlying causes:
- gastric erosions, GI cancer
Prophylaxis with an iron appropriate in
Malabsorption
Menorragia
Pregnancy
After subtotals or total gastrectomy
In haemodylsis patients
In the management of low births weight infants such as preterm neonates
What are the sing and symptoms of iron deficiency
Tiredness
SOB
Palpitations
Pale skin
What is iron
Ferrous fumerate, glconate, surface and surface dried
Daily elemental iron dose- 60-70mg per day
Side effects
Constipation or diarrhoea
Black tarry stool
Best taken with vitamin c for better absorption
When haemoglocin is within normal range- continue for 3 more months
Toxicity is treated with desferrioxamine
Taken after food to reduce the side effects
Taken before food for best absorption
When would you stop taking iron supplements
If you have confirmed c.diffe as can cause diarrhoea
What is parental iron
Iron dextran, iron sucrose, ferric carboxymaltose or ferric derisomaltrose
Used when:
Oral therapy is not tolerated/ doesn’t work
Chemotherapy induced anaemia
Chronic renal failure who are receiving haemodiaylsis
What is the MRHA warning about parental iron
Serious hypersensitivity reactions with intravenous iron
Appropriately trained staff and resuscitation must be available
Monitor the hypersensitivity for at least 30 minutes after every administration
What is meant by megaloblastic anaemia
Can be wither vitamin b12 or folate deficiency ( first step is the established cause )
Malabsorption of vitamin b12
-give hydroxoxobalamin (vitamin b12) at intervals of up to 3 months
-treatment initiated with frequently I’m injections to replenish stores- then maintenance
Folate deficiency
Due to poor nutrition, pregnancy or anti epileptic drugs
Daily folate supplements for 4 months
Emergencies
Administer both white plasma assay results are awaited
Don’t give folic acid alone if undiagnosed may give neuropathy
What is folic acid
Two doses
Regular pregnancy: 400mcg daily before conception til week 12 of pregnancy
Risk of NTDS: 5mg daily before conception til week 12 of pregnancy
Risk factor of neural tube defects
Smoking
Sickle cell anaemia
Diabetes
Obesity
Use of anti epileptic drugs
Use of anti malarial drugs
