Anemia Flashcards
What is anemia defined as
a decrease in hemoglobin and hematocrit
What is the purpose of Hgb
to carry oxygen
What are immature RBCs called
reticulocytes
What are three things that cau cause anemia?
1) nutritional deficiencies - iron, folate, b12
2) complication of another medical disorder like CKD
3) due to a malignancy
What are symptoms of anemia
fatigue, headache, exercise intolerance, diziness, anorexia, pallor
glossitis
inflamed sore tongue
kolionycias
thin, conave spoon shaped nails
pica
craving non foods such as chalk or clay
cobalmin
b12
b12 deficiency presentation
peripheral neuropathies
What does MCV tell you?
size of RBC
MCV <80
microcytic
likely due to iron deficiency
MCV 80-100
Normocytic
likely cause: acute blood loss, malignancy, CKD, bone marrow failure (aplastic anemia, hemolysis
MCV >100
macrocytic
likely cause either B12 or folate deficiency
Causes of iron deficiency anemia
1) iron poor diets (vegetarian)
2) Blood loss
3) Decreased iron absorption
4) Increased iron requirements - pregnancy, lactation
Reticulatocyte cell is low in untreated anemia and with bone marrow supression because
in order to form they take up hgb and iron in the bone marrow
Ferrous sulfate dosing and percent elemental iron
325 mg PO daily to TID, 65mg elemental iron which is 20%
what form of iron is used in dialysis
parenteral
desferal
deferoxamine which is the antidode for iron overdose
side effects of oral iron
constipation, dark tarry stoools - may give docusate
Administration of oral iron
food decreases absorption so take on empty stomach **, acidic environment increases absorption so avoid any meds that supress acid, sustained release causes less gi irritation
What classes of meds should iron be separated from by 2 hours before and 4 hours after
antacids/h2ras/ppi
levothyroxine (seperate by 2-4 hours after)
quinalone/tetracycline antibiotics
What should you give iron with to increase absorption
vitamin c
How to administer iron with bisphosphonates (alendronate/risedronate, oral ibandronate)
alendronate/risendronate - 30 minutes
ibandronate - 60 min
