Module 4: Iron deficiency anemia tx

Question 1

Indication for tx?

Answer 1

All patients with iron deficiency anemia should be treated as carries a risk for progression including severe anemia with organ damage.

Question 2

When is oral vs IV iron recommended?

Answer 2

For pts with uncomplicated iron deficiency who tolerate oral iron, oral is recommended due to ease of administration.

IV iron for:
- individuals with ongoing blood loss, IBD, CKD, gastric sx or other anatomic abnormality that interferes with absorption.
- second and third trimesters
- when more rapid correction is needed.

Question 3

When is transfusion indicated?

Answer 3

RBC transfusion is for severe anemia, severe symptoms (MI), or hemodynamic compromise.

Question 4

What is the frequency and duration for oral iron supplements?

Answer 4

Efficacy similar with daily or every other day dosing which may decrease adverse effects.

Duration - some experts stop when Hgb normalizes, others continue for an additional 6 months

Question 5

What are the most common adverse effects?

Answer 5

GI = metaillic taste, N/V, flatulence, constipation, diarrhea

Question 6

What measures can be taken to improve absorption and tolerability?

Answer 6

Take every other day, dietary modifications, switch to liquid formulation.