Exam I, Linger, anemia Tx, lec Part I Flashcards
What are the oral preparations for iron
ferrous sulfate
ferrous gluconate
ferrous fumarate
what are the parenteral preparations for iron
iron dextran
iron-sucrose complex
sodium ferric gluconate complex
What are the iron chelators
deferoxamine
deferasirox
what are the Vit B12 preperations
cyanocobalamin
what are the erythrocyte stimulating agents
epoetin alpha
darbepoetin alpha
what are the myeloid growth factors that are granulocyte colony stimulating factors
filgrastim(neupogen)
pegfilgrastim
what are the myeloid growth factors that are granulocyte macrophage colony stimulating factors
sargramostim
what are the megakaryocyte growth factor stimulants
oprelevekin (IL-11)
romiplostim
Sx of anemia
pallor fatigue, dizziness, exertional dyspnea
tissue hypoxia, tachycardia, increased CO and vasodilation
what do RBC look like in iron deficiency
microcytic hypochromic anemia
where does most iron absorption occur
duodenum and proximal jejunum
which iron has to be broken down by ferroreductase to be absorbed
nonheme iron
what occurs when iron stores are high
absorbed iron is diverted into ferritin in the intestinal epithelial mucosal cells for storage
what transports iron into the plasma
transferrin, beta globulin
how is ferrous iron transported
divalent metal transporter 1 into cell and enteres Hb synthesis pathway or stored as ferritin
how does iron uptake change in situations of increased erythropoiesis
increase in # of tranferrin R n developing etythroid cells
where is iron stored
intestinal mucosal cells in macrophages in liver, spleen and bone and in the parenchymal liver cells
how does low level of iron change apoferritin levels
inhibits its synthesis
What is the ONLY clinical indication for use of iron preparations
Tx or prevention of Fe deficient anemia
when giving patient ferrous sulfate or any other iron supp what should you tell them to do when taking the medicine
take with water or juice on empty stomach
with food to prevent irritation if need be
adverse effects of oral iron therapy
nausea, epigastric discomfort, abdominal cramps, constipation, black stools and diarrhea
when do you use parenteral iron therapy
patient cannot tolerate oral iron or patients with advanced chronic renal disease requiring hemodialysis and Tx with erythropoietin, small bowel resection etc
how does pareneteral iron avoid severe toxicity from free ferric iron at administration
colloid particles with core of oxyhydroxide surrounded by carbohydrate
Fe is released slowly
Need to monitor iron storage levels
how is iron dextran administered and side effects?
IM or IV (usually IV)
HA, light headedness, fever, arthralgias nausea, vomiting, back pain, flushing, urticaria, bronchospasm, anaphylaxis and death
