RBC Pharm Flashcards
Ferrous Sulfate
–oral form of iron
Indications for iron supplementation
–treat and prevent iron deficiency anemia
–treat blood loss
interactions for iron supplements
–decrease absorption with antacids
–increase absorption with Vitamin C
adverse effects of iron supplements
–GI (nausea, heartburn, constipation)
–metallic taste
–staining of teeth
–fatal iron toxicity
–leading cause of poisoning death in children
chelating agent for iron supplements
deferoxamine/Desferal
parenteral form of iron supplementation
iron dextran
how should oral iron be taken?
through a straw
specifics of oral iron administration (tablets)
–best absorbed on empty stomach
–do not crush or chew
–do not give with antacids or calcium supplements
–taking with food decreases gastric irritation, but shouldn’t be done forever (first couple of weeks okay)
specifics of oral iron administration (liquid)
–give with straw and dilute in OJ to increase absorption
–monitor for teeth staining with liquid form
specifics of parenteral iron administration
–give test dose
–IM: use 1.5-inch needle with Z track technique to prevent skin staining
black box warning for iron dextran
have epi available for possible allergic reaction (dextran portion of med)
diet for B12 deficiency
–meat
–salmon and cod
–milk and dairy
–eggs
medication for B12 deficiency
cyanocobalamin
diet for folate deficiency
–leafy green veggies
–legumes
–organ meats
–fortified grains
medications for folate deficiency
–multivitamin supplements
–OTC folic acid supplements
indications for cyanocobalamin
–low B12
–pernicious anemia
–bariatric surgery patients (1mg lifelong)
–surgeries where part of or whole stomach is removed
oral amount of cyanocobalamin recommended
1-2mg daily
specifics about injectable cyanocobalamin
–IM weekly until levels are almost normal, then monthly
–more rapid improvement
–indicated for patients with severe deficiency or neuro sx
–well tolerated
indications for folic acid supplementation
–treat folic acid deficiency anemia
–in pregnant women to prevent neural tube defects
usual dose of prescription strength folic acid
1-5 mg daily; tablets or liquid
usual dose of OTC folic acid
400 mcg/daily
MOA of erythropoietin stimulating agents
–stimulates erythropoiesis
–increases Hgb and reticulocyte counts
indication for epoetin alfa
–ONLY when Hgb is <10 g/dL
–treatment of anemia due to chronic kidney disease
–HIV patient on drug zidovudine
–people on chemo
–autoimmune hemolytic anemia
route for epoetin alfa
IV and SQ
monitoring for epoetin alfa
–weekly blood tests to monitor Hgb with goal of <11 to decrease risk for clotting (polycythemia)
–evaluate iron status before and during treatment
side effects of epoetin alfa
–HTN and serious CV events
–progression of certain cancers
–injection site problems, bone pain, headache
black box warning for epoetin alfa
patients had higher chance for stroke and heart attack if admin ESAs to a target Hgb > 11
nursing implications for ESAs
–do not give if it has been shaken or frozen
–protect from light
–do not dilute or mix with other drugs
–contraindicated in patients with uncontrolled HTN
–may be given IVP
–levels of Hgb begin to rise in about 2 weeks
