CH 39: Anemia & Hematopoietic Growth Factors

Question 1

Ferrous Sulfate - Adverse effects?

Answer 1

• N/V
• brown stains on teeth from liquid
• darkened stools
• constipation

Question 2

Ferrous sulfate - contraindications/precautions?

Answer 2

• hemochromatosis
• PUD
• regional enteritis
• ulcerative colitis

Question 3

Considerations for Ferrous Sulfate?

Answer 3

• assess VS for cellular hypoxia
• give on empty stomach, if possible
• if difficulty swallowing tablets or capsules, recommend a liquid formulation or less corrosive form, such as ferrous gluconate
• prevent staining of teeth (rinse with h2o)
• mix Feosol elixir w/ h2o
• continue iron therapy for 2-3 months after normal Hgb
• baseline levels for RBCs, hematocrit, hemoglobin, and serum ferritin
• monitor BMs

Question 3

Ferrous sulfate - patient and family education

Answer 3

• don’t take tablets or capsules within 1 hour of bedtime
• don’t crush tablets or empty contents of capsule
• take ferrous sulfate with full glass of water
• rinse mouth with clear h2o immediately after ingestion
• consume citrus fruit or tomato juice with iron preparations (except elixir form)
• dark green or black stools = harmless SE
• report constipation or diarrhea

Question 4

what foods to not take with ferrous sulfate?

Answer 4

avoid taking with:
- milk
- eggs
- antacids
- caffeine beverages

Question 5

cyanocobalamin - what is it for?

Answer 5

T: agent for anemia
P: vitamin supplement
- for vit b12 deficiency anemia

Question 6

cyanocobalamin - adverse effects?

Answer 6

• rashes
• itching
• other signs of allergy

Question 7

cyanocobalamin - serious adverse effects?

Answer 7

• sodium retention with possible worsening HF
• anaphylaxis
• hypokalemia & potential dysrhythmias

Question 8

Cyanocobalamin - contraindications / precautions?

Answer 8

• suspected sensitivity to cobalt
• severe pulmonary disease
• heart disease

pregnancy category A, category C when used parenterally

Question 8

cyanocobalamin - any drug interactions?

Answer 8

can decrease absorption
- ethanol/ alcohol
- aminosalicylic acid
- omeprazole
- neomycin
- chloramphenicol

Question 8

cyanocobalamin - any considerations?

Answer 8

• monitor lab tests; repeat test 5-7 days after start of therapy, and @ regular intervals during
• monitor serum K+ levels during first 48h
• pts w/ cardiac disease and those on parental cyanocobalamin @ risk for dysrhythmias, palpitations & CP - watch VS
• be alert to s/s pulmonary edema
• monitor effectiveness of pharmacotherapy
• complete diet + drug hx
• inquire into alcohol drinking patterns