Anaemias Flashcards
Sickle cell anaemia - what is it and what is its treatment?? It can lead to what??haemolytic anaemia treated with what??what does hydroxycarbamide reduce the frequency of??
Deformed, less flexible red blood cells
- acute complications - sickle cell crisis - restricted blood supply to organs
- hospitalisation - fluid replacement, analgesia, treats any infections
- complications: anaemia, leg ulcers,renal failures, susceptibility to infections
- if patient has haemolytic anaemia - increase folate (folic acid supplementation)
- hydroxycarbamide reduces frequency of painful crises and reduces requirements
G6PD Deficiency
- common in Africa and Asia - more common in males than females
- susceptible to developing acute haemolytic anaemia
- drugs with definite risk if haemolysis in most G6PD deficient individuals
- dapsone and other self ones,fluroqunilones, nitrofuratoin, quinones
Haemolysis - red blood cell destruction
Drugs with possible risk of haemolysis in some G6PD deficient individuals - aspirin, chloroquine, menadione,quinine, sulfonylureas
Iron deficiency - must show what to be treated?? Excludes what?? Prophylaxis of iron when is it appropriate ?? Signs and symptoms??
Must be able to show iron deficiency to treat with iron preparation
Exclude serious underlying causes- gastric erosion,gastro-intestinal cancer
Prophylaxis with iron appropriate in:
- malabsorption
- menorrhagia
-pregnancy
- after subtotal of total gastrectomy
- in haemodialysis patients
In the management if low birth weigh infants such as pre term neonates
- signs and symptoms - tiredness, shortness of breath M palpitations,pale skin
Types of iron
Ferrous fumerate, glauconite,sulfate,sulfate(dried)
Daily dose of iron
100 to 200 mg
- usually as ferrous (dried) can also be mr to - reduces absorption
Take after food to reduce side effects, take before food for best absorption
Side effects of iron?
Constipation or diarrhoea
Black tarry stool
Iron to be taken with… when haemoglobin is in normal range how long do we continue it for?? What is toxicity treated with???
- vitamin C to aid absorption
-when haemoglobin is in normal range - continued for 3 more months - toxicity treated with desferrioxamine
Parenteral iron - examples??
Iron dextran,iron sucrose, ferric carboxymaltose or ferric dersomaltose
Iron parenteral - is used when
Used when-
Oral therapy not tolerated
Chemotherapy induce anaemia
Chronic renal failure who are receiving haemodialysis
IV IRON MHRA WARNING
- Appropriately trained staff and resuscitation must be available
- monitor hypersensitivity for at least 30 mins after administration
Megaloblastic anaemia is treated how?? How long is b12 given for??
- Can either be vitamin B12 or folate deficiency (first step = establish cause)
- malabsorption of vitamin b12
- give hydroxycobalamin (vitamin b12) at interverals of up to to 3 months
- treatment initiated with frequent IM injection to replenish stores - then maintenance
Folate deficiency - is due to what and when is it most likely??
- Due to poor nutrition, pregnancy or anti epileptic drugs
- Daily folic acid supplementation for 4 months
Emergency folate deficiency
Don’t give folic acid without what?
- Administer Both while plasma assay results are awaited
- don’t give folic acid if undiagnosed - may cause neuropathy
Folic acid - what are the 2 doses and when when are they regularly given??
Two doses:
- regular pregnancy - 400mg daily from before contraception till week 12 pregnancy
- risk of NTDs: 5mg daily from before contraception till week 12 of pregnancy
Risk factors neural tube defects:
- smoking
- sickle cell anaemia
- diabetes
- obesity
- use of anti- epileptic drugs
- use of anti malarial drugs
Dose of iron decreased to 60-70 Per day
