Iron Polymaltose

Question 1

What is iron polymaltose?

Answer 1

parenteral administration of iron.
parenteral iron is reserved for use when oral therapy is unsuccessful because patient cannot tolerate oral iron or does not take it reliably, or there may be continual blood loss, or in cases of malabsorption

Question 2

What class of drugs does iron polymaltose belong to?

Answer 2

haempoietic agents

iron preparations

Question 3

what are other drugs in the same class as iron polymaltose?

Answer 3

erythropoetin

Question 4

What is iron polymaltose indicated for?

Answer 4

iron deficiency anaemia when:

• oral therapy is contraindicated
• enteric absorption of iron is defective
• patient non compliance, or persistent GI intlerance making oral therapy impractical
• treating iron deficiency anaemia of prematurity, and that occuring in geriatric patients
• treating iron deficiency states discovered in the 3rd trimester of pregnancy
• anaemia resulting from excessive blood loss
• contact between patient and doctor occurs at irregular intervals

Question 5

WHat is the dose of iron polymaltose given for iron deficiency anaemia?

Answer 5

based on weight:
Iron dose (mg) = Hb-iron deficiency + iron depot.

Hb-iron deficiency = body weight(kg) x (target Hb-actual Hb in g/L) x 0.24

Question 6

What is the mechanism of action of Iron polymaltose?

Answer 6

Iron polymaltose comes into contact with iron binding sites at the mucosal surface resulting in a physiological exchange. Iron polymaltose then releases the required amount of ferric iron which is actively transported into the mucosal cell by a carrier protein, and then released for binding to ferritin or transferrin

Question 7

What are the main PK and PD parameters of iron polymaltose?

Answer 7

PK:
terminal half life 22.4 hours
Volume of distribution 2.93L
Renal elimination <1% of total dosage

Question 8

What are the precautions associated with iron polymaltose use?

Answer 8

do not give until 7 days after last injection
infection (discontinue if ongoing bacteraemia)
hypersensitiviy reactions
not for injection into arm, exposed areas
renal hepatic insufficiency
folic acid defiiency,
inflammatory disease,
Lupus
neonates
pregnancy 2nd and 3rd trimesters

Question 9

What are the contraindications associated with iron polymaltose use?

Answer 9

Oster-Rendu-Weber syndrom
chronic polyarhtirits
active RA
uncontrolled hyperparathyroidism
decompensated hepatic cirrhosis
infectious hepatitis
severe inflammation or infection of kidney or liver
during 1st trimester of pregnancu

Question 10

What are the adverse effects of iron polymaltose use?

Answer 10

less common: injection site reactions
nausea
vomiting
faintness
syncope
tahyardia
hypotension
circulatory collapse
flushing
bronhospasm with dyspnoea,
hypersenstiivity reations,
fever, hills, sweating
generalised lymphadenopathy
joint and muscle pain
arthralgia
sensation of stiffening of arms, legs, face, 
Chest and back pain
rash
urticaria

Question 11

What are the drug interations associated with iron polymaltose?

Answer 11

Antacids: absorption of oral iron reduced
calcium salts: absorption of oral iron is reduced

antibacterials: oral iron reduces the absorption
bisphosphonates: oral iron reduces the absorption
thyroid hormones: oral iron reduces the absorption

Zinc: both zinc and oral iron absorption is reduced.

Question 12

What are the alarm bells with iron polymaltose use?

Answer 12

hypersensitivity reactions more likly in patients with history of allergic disorders
facilities for cardiopulmonary resuscitation should be available

Question 13

What sort of monitoring is involved in iron polymaltose therapy?

Answer 13

monitor patient during, and for 30-60 minutes after every infusion