Anemia Lecture Flashcards
Is iron tolerated for pts? _________,aftertase, GI upset
constipation,
How often do you take iron? pts can take iron up to 3 times a day and its hard for absorption in alot of cases
IV Iron
Patients who need more ________repletion
Cannot be treated with oral iron
Higher risk of adverse effects
Pts w/symptomatic anemia
Examples: Severe iron deficiency TSAT less than 12%
Severe anemia hemoglobin less than 7g/L in asymptomatic pts
Risk of ongoing blood loss such as a pt w/chronic gastrointestinal blood loss)
History of side effects oral iron
History of not responding to oral iron in the past
rapid
symptomatic anemia
How long does it take to boost iron levels in a human body?
up to months
Initially we try to put nondialysis pts on oral iron because its cheap and more tolerable than IV therapy in terms thats it more readily available, you don’t need IV access, there’s no increased risk of infection
PO iron
Most nondialysis CKD pts receive PO
Inexpensive
Readily available
______access needed
No IV access needed
what would be some reasons we couldn’t treat pts with oral iron? pt can’t swallow and they are unresponsive, pt has a GI bleed
Ferrous sulfate (oral iron, most commonly used)
Dosed 325mg ________times per day
Space from _________or calcium containing products
Take on an __________stomach
Adverse effects: Constipation,black stools, bloating
Poor adherence
Poor absorption (sometimes administered with vitamin C in non CKD pts)
3 times per day
antacids
empty stomach
Pts w/chronic kidney disease should not be given vitamin C because they will develop kidney stones
Adverse effects of IV iron
_________/ __________(especially in dextran derivatives this happens)
Hypotension
Dizziness,dyspnea, syncope
Headaches,
Lower back pain
Arthralgia
Potential for increased risk of infection (due to IV access)
Allergic reactions/ anaphylaxis
How can we prevent anaphylaxis in pts about to take IV iron?
give them benadryl, or a test dose of the medication to monitor pt and see what happens
Dyspnea is trouble breathing
Iron Dextran
Carry a black box warning about fatal anaphylactic reactions
A 25mg _________required
Newer IV iron formulations do not contain dextran or have lower amounts therefore better safety profile
Lower molecular weight vs high molecular weight
test dose required
Ferumoxytol (Feraheme)
IV formulation
Contains dextran derivatives
Does not require what?
Does not require test dose
Ferric Carboxmaltose (Injectafer)
_________-free product
Weight based dosing
Dextran free product
Ferric Derisomaltose (Monoferric)
Weight based dosing
A little bit of dextran added to this
hypersensitity reaction from this
