Pharmacology of Anemia Flashcards
Where is most of the iron in the body found?
In hemoglobin
What form of iron is absorbed?
Ferrous (Fe2+)
Transferrin
Transferrin takes iron to bone marrow
Ferritin
Ferritin takes iron to plasma/liver/spleen
Ferroportin
Exports iron from the small intestine
What can be used to estimate iron stores in the body?
Ferritin in plasma is in equilibrium with body storage and can be used to estimate total body stores
Hepcidin
Downregulates ferroportin
How does anemia of chronic disease (ACD) affect hepcidin?
It increases hepcidin levels which will decrease ferroportin and decrease iron uptake
What are the transferrin and ferritin levels in iron deficiency?
Ferritin is low to store less iron
Transferrin is high
What are the transferrin and ferritin levels in iron overload?
Ferritin is high to store more iron
Transferrin is low
What population has increased iron requirements?
- premature infants
- children
- pregnant or lactating women
What is used as oral iron therapy?
Ferrous sulfate, ferrous gluconate, ferrous fumarate
When is parenteral iron therapy used?
Indicated when oral iron is not tolerated, post GI resection, malabsorption syndromes
What is acute iron toxicity?
(1) May be fatal in small children
(2) Necrotizing gastroenteritis
(3) After short improvement, metabolic acidosis, coma and death
What is chronic iron toxicity?
Seen in hemochromatosis, multiple red cell tranfusions and it leads to organ failure like heart failure
How is acute iron toxicity treated?
- Gastric aspiration
- Gastric lavage-phosphate or carbonate solutions
- Iron chelation (deferoxamine)