GI: IRON

Question 1

IRON: INDICATIONS

Answer 1

• Iron deficient anaemia
• Prophylaxis of iron-deficient anaemia -> particularly in patients with risk factors such as poor diet, malabsorption, menorrhagia, gastrectomy, haemodialysis and infants with low birth weight

Question 2

IRON: MOA

Answer 2

• Replenish iron stores (required for erythropoeisis, synthesis of haem component of Hb = red blood cells)
• Iron best absorbed in its ferrous state in the duodenum and jejunum -> absorption increased by stomach acid and by Vit C
• Once absorbed in the blood stream iron is bound to transferrin, and T transports it to either be used in bone marrow for erythropoiesis or to be stored as ferritin in the liver, reticuloendothelial system, bone marrow, spleen and skeletal muscle

Question 3

IRON: ADVERSE EFFECTS

Answer 3

• GI upset (nausea, epigastric pain, constipation and diarrhoea)
• Bowel motions may turn black on Tx
• IV Iron (injection site irritation, HS Rxns including anaphylaxis)

Question 4

IRON: WARNINGS

Answer 4

• Oral therapy exarcebates bowel symptoms in patients with intestinal dx (IBD, diverticular dx and intestinal strictures)
• IV iron should be used with caution in people with an atopic predisposition due to the risk anaphylactic rxn

Question 5

IRON: INTERACTIONS

Answer 5

• Oral iron salts can reduce the absorption of other drugs including levothyroxine and bisphosphonates
• These meds should be taken at least 2 hours before oral iron

Question 6

IRON: EXAMPLES

Answer 6

• Ferrous Fumarate

- Ferrous Sulfate