Chapter 9 Nutrition and Blood Flashcards
what conditions require iron prophylaxis
heavy period pregnancy malabsorption gastrectomy dialysis low birth weight infants
iron salts
iron salts are given mouth
little difference between the salts
choice dependant on side effects and cost
oral elemental iron for iron deficiency anaemia should 100-200mg daily usually as ferrous sulphate
what are the amounts of iron each iron each salt
ferrous fumarate 210mg- 65mg
gluconate 300mg- 35
ferrous sulfate dried 200mg- 65mg
ferrous sulphate 300mg
iron and folic compounds
iron and folic acid
used in pregnancy in women who are at high risk of developing iron folic acid deficiency 400mcg
folic acid 5mg for neural tube defects
some preps contain ascorbic aci to aid absorption
examples of iv iron
iron sucrose iron dextran ferric carboxymaltose iron isomaltoside 100 unsuccessful oral
when to give parenteral iron
oral therapy unsuccessful continued blood loss haemodialysis chemo malabsorption
side effects of iron
diarrhoea- oral MR can exacerbate this in IBS constipation- more likely in elderly black starry stool gi irritation nausea epigastric pain
COUNSELLING for iron tabs
take after to reduce side effects
best absorbed on empty stomach
discolours stools
what is G6PD Deficiency
Genetic: heterogenous so safe in some and not in others - most common in africans, asians, oceania and south europe and in men
bresk down of red blood cells due to
when you take certain drugs or eat fava beans it causes haemolytic anaemia
risk and severity is dose related
which drugs can cause anaemia in pts with g6pd defiiency
dapsone and other sufones nitrofurantoin gluroquinolones sulponamides quionilones e.g nalidix acid
which drugs pose a possible riskof anaemia in g6pd deficeny ppl
sulphonyureas
aspirin
chloroquine
quinine
what is oral replacement therapy and how does it work?
intestinal absorption of sodium and water is enhanced by glucose and carbs
replaces electrolyet deficit safely
contains alkalising agent to neutralise the acidosis
slightly hypo-osmolar so prevents possible indcution of osmotic diarrhoea
Simple to use in a hospital and home
palatable, child friendly and readilty available
what are hydroxycolbalamin used for
prophylaxis for anemias assocaited with vitamin B12 deficiency
used over cyanocolbalamin because this stays in the bosy for too long
given at 3 month intervals
what is folic acid megaloblastic anaemia
megaloblastic anaemia- due to lack of vitamin b12 or folic acid
another cause is pernicious anaemia
folic acid need to take for 4 months before seeing the benefits
when is folic acid used, what strenghth and for how long
gievn in pregnancy, poor nutrition, antiepileptics, methotrexate
folate deficiency in megaloblastic anemia as well as prophylaxis
taken before and during pregnancy to reduce chance of neural tube defects
women at low risk take 400mcg- taken 12 weeks into pregnancy
women at high risk take 5mg up to 12 weeks
high risk couples e.g one partner had a defect or family hostory or malabosption stte- sickle cell, diabetes, anti-epileptics meds
what is epoetins used for
treat aneamias where ther are low blood cells- such as in aki
darbapoetin has a longer half life
what is sicke cell
what medicine can be used to reduce frequency of crises
what are the complications
abnormal shape of haemoglobin resulting in reduced amount of oxygen to organs and severe pain
increased susceptibility to infection and various vaccines required and prophylatic peniciillin
hydroxycarbamide can reduce frequency of crises and for blood transfusion
chronic complications include: skin infections renal failure and increased risk of infections
what is folinic acid
effective treatment in folate deficiency megaloblastic anaemia but used with cytotoxics
given as calcium foliate
what is magnesium used for in the bosy
essential constituent of many enzymes systems
involved in energy generation
not well absorbed in GI
Largest stores in skeleton
s/e= diarrhoea
interupt treatment and restart at reduced dose if side effects occur
effects of zinc defiency
what condition is zinc usde totreat
only give wen there is deficiency
occurs: malabsorption, trauma, burns, protein losing conditions, inadequate diet
used to treat wilsons disease which is a rare inherited abnormality of zinc absorption
what conditions require TPN- Total
gives electrolytes IV -Undernourished pts chemo radiotherapy major surgery kideny failre
what is in tpn
amino acids trace elements glucose fats Electrolytes vitamins
what are special diets
what is phenylketonuria and what are teh symptoms
preparations modified to elimate a particular consistent of food
Phenylketonuria - inability to breakdwon amino acid phenylalanine
common in aspartame containing producst
symptoms include: mouldy smell to breath, tremors, epilepsy, eczema, brain damage
when is phospate replacement required
oral phosphate supplements and vitamin d required in pts with hypophosphataemic vitamin D resisitant rickets
phosphate infusion can be used in alchol depedence
phosphate depletion occurs in severe ketoacidosis
sevelamer and lanthanum licensed for hyperphosphataemia for pts on dialysis
