Iron Supplements

Question 1

Give 2 examples of iron supplements

Answer 1

• Ferrous sulphate

- Ferrous fumigate

Question 2

What is the mechanism of action of iron supplements?

Answer 2

Increases the iron stores contained in the body

Question 3

What is iron required for?

Answer 3

Erythropoiesis and haemoglobin synthesis

Question 4

What happens if iron deficiency is present?

Answer 4

Anaemia and symptoms of reduced oxygen-carrying capacity, e.g. shortness of breath, can occur

Question 5

What are the routes of delivery of iron supplementation?

Answer 5

• PO

- IV infusion

Question 6

When should IV infusion of iron be used?

Answer 6

Reserved for specialist use only where the patient is acutely unwell

Question 7

What route of iron supplementation are allergic reactions common?

Answer 7

Parenteral route

Question 8

What are the indications for iron supplements?

Answer 8

Treatment and prophylaxis of iron deficiency anaemia

Question 9

Why should you confirm that iron deficiency is the cause of anaemia before giving iron supplementation?

Answer 9

There is a risk of iron overload if patients with sufficient iron stores are treated with supplementary iron

Question 10

What are the contraindications/cautions to iron supplementation?

Answer 10

• Peptic ulceration
• Known hypersensitivity to aspirin or NSAIDs
• Avoid in patients with strictures or diverticula

Question 11

What monitoring is required with iron supplements?

Answer 11

Take note of any side effects when reviewing patient

Question 12

What might iron supplements interact with?

Answer 12

• Quinolones
• Tetracyclines
• Penicillinamine
• Levodopa

Question 13

What might happen if these drugs are given with iron supplements?

Answer 13

They can reduce the absorption of these drugs when taking oral iron because the iron salts form chelates with these drugs

Question 14

What are the common side effects of iron supplements?

Answer 14

• GI disturbances, particularly constipation

- Black tarry stools

Question 15

What patient counselling is required with iron supplementation?

Answer 15

• Side effects
• Black and tarry stools
• Taking vitamin C with iron
• Compliance before colonoscopy
• Keep iron tablets away from children

Question 16

What patient counselling is required regarding side effects with iron supplementation?

Answer 16

Explain common side effects of iron therapy are nausea and GI disturbances such as diarrhoea, constupation, and epigastric pain. Iron tablets can be taken with food to reduced GI disturbance

Question 17

What patient counselling is required regarding black and tarry stools with iron supplementation?

Answer 17

Warn patient that oral iron can cause this, and not to worry if this occurs after commencing treatment

Question 18

What patient counselling is required regarding taking vitamin C with iron?

Answer 18

Advise patient that taking vitamin C can increase the uptake of iron, so they might want to consider taking vitamin C supplements in conjunction with iron tablets to increase the efficacy of treatment

Question 19

What patient counselling is required regarding taking iron before colonoscopy?

Answer 19

If patient is having colonoscopy, may need to stop iron supplementation in advance of procedure for visualisation purposes (easier to see during colonoscopy if stools are not black and tarry)

Question 20

How long before colonoscopy should iron supplements be stopped?

Answer 20

Usually 1 week, but specific advice should be sought from team performing the procedure

Question 21

Why should iron tablets be kept out of reach of children?

Answer 21

Iron poisoning can be fatal