Blood and Nutrition

Question 1

Ferrous sulphate, ferrous fumarate

Answer 1

Used in iron deficiency anaemia to allow regeneration of haemoglobin.
Don’t take with food unless to alleviate GI effects
ADRs: Discolouration of stools, GI irritation, altered bowel habits.

Question 2

Hydroxocobalamin

Answer 2

Used in B12 deficiency anaemia and pernicious anaemia - IM injection
ADRs: nausea, headache, dizziness, hypersensitivity, fever, hypokalaemia, thrombocytopenia

Question 3

Folic acid

Answer 3

Used in folate deficiency megaloblastic anaemia

ADRs: GI disturbances

Question 4

Calcium resonium

Answer 4

(calcium polystyrene sulfonate) Used in the management of mild-moderate hyperkalaemia with no ECG changes - ion exchange resin
ADRs: faecal impaction if given rectally, gastro-intestinal concretions if given orally, intestinal necrosis if used with sorbitol, gastric irritation, nausea, vomiting, constipation

Question 5

Sodium Chloride solution

Answer 5

Parenteral fluid given in sodium depletion such as gastro-enteritis, diabetic ketoacidosis, ileus, and ascites
ADRs: sodium accumulation, oedema, hyperchloraemia acidosis

Question 6

Glucose solution

Answer 6

Parenteral fluid - indicated in fluid replacement (fever, hyperthyroidism, diabetes insipidus) and hypoglycaemia
ADRs: low pH - venous irritation and thrombophlebitis

Question 7

How would you treat hyperkalaemia?

Answer 7

If over 6.5 mmol/litre or ECG changes then give Calcium Gluconate to protect the myocardium.
Give soluble insulin with glucose to avoid hypo
Give salbutamol - nebulised or IV
Correct acidaemia
Review prescription of drugs precipitating hyperkalaemia
Haemodialysis