Translate

Treatment of Iron deficiency anemia

Drugs used in the management of anemia

Most appropriate oral iron therapy is use of a tablet containing ferrous salts

+ Ferrous sulfate

+ Ferrous fumarate

+ Ferrous gluconate

Parenteral iron therapy for iron deficiency anemia

• Iron dextran injection
• Iron sucrose injection
• Sodium ferric gluconate complex injection.


Reserve parenteral iron for
• patients who are unable to absorb oral iron
• Rarely given when patients cannot tolerate oral form
• If iron loss exceeds oral iron replacement
• Patients with inflammatory bowel disease,as the ferrous sulfate preparations may aggravate the
intestinal inflammation.

Other ant anemic drugs
• Folic acid; used in management of anaemia and neuro tube defect.
  • Hydroxocobalamin is also known as vitamin B12, it is used in management of megaloblastic anaemia.



Contraindications:

• Ferrous sulphate is not contra-indicated to specific group of individual but should be given with care to those people with peptic ulcers.

• Folic acid is not contra-indicated to specific group of individual but should never be given alone for pernicious anaemia and other vitamin B12 deficiency states since it may precipitate subacute combined degeneration of the spinal cord.

• Hydroxocobalamin is not contra-indicated to specific group of individual but should not be given before diagnosis fully established.

• Iron dextran Injection is contra-indicated to those with history of allergic disorders including asthma and eczema, infection, active rheumatoid arthritis, severe hepatic impairment and acute renal failure.

Dose, Dosage and Course of treatment

Ferrous sulphate
• Dose prophylactic, 1 tablet (200mg) daily; therapeutic, 1 tablet 2–3 times daily until signs and symptoms disappear.

Folic acid
• Folate-deficient megaloblastic anaemia, by mouth, adult and child over 1 year, 5 mg daily for 4 months (until term in pregnant women); up to 15 mg daily may be required in malabsorption states;

• Children under 1 year, 500 micrograms/kg daily (max. 5 mg) for up to 4 months; up to 10 mg daily may be required in malabsorption states

Hydroxocobalamin
• By mouth, vitamin B12 deficiency of dietary origin, 50–150 micrograms daily taken between meals children 50–105 micrograms daily in 1–3 divided doses.

• By intramuscular injection, initially 1 mg repeated 10 times at intervals of 2–3 days, maintenance 1 mg every month.

Iron dextran Injection
• By deep intramuscular injection into the gluteal muscle or by slow intravenous injection or by intravenous infusion, 50mg/mL, 2ml ample or calculated according to bodyweight and iron deficit.

• The product is not recommended to children under 14 years.

Side Effects and Adverse Effects

Oral Iron Therapy:
• Gastro-intestinal irritation
• Nausea and epigastric pain
• constipation, black stools,
• Oral iron, particularly modified-release preparations, can exacerbate diarrhea

Folic acid:
Not common, rarely gastro-intestinal disturbances

Hydroxocobalamin:
• Nausea, headache, dizziness and fever
• Hypersensitivity reactions (including rash and pruritus) may occur.
• Injection-site reactions
• Hypokalaemia
• Thrombocytosis (An increase in the number of platelets in the circulating blood.)
• Chromaturia (abnormal coloration of the urine.)

Parenteral iron therapy side effects:

Not common, they may include;
• Nausea, vomiting and abdominal pain
• Flushing, dyspnoea and anaphylactic reactions
• Numbness, cramps and blurred Vision
• Pruritus, and rash;

Interactions and Precautions

Ferrous sulphate
• Vitamin C can facilitate iron absorption

• Absorption of Ferrous sulphate is reduced by oral magnesium salts, calcium salts and zinc.

• Ferrous sulphate reduces absorption of ciprofloxacin and other fluoroquinolones, levodopa, mycophenolates, Penicillamine, bisphosphonates and levothyroxines

• Folic acid; usually does not interact with any specific group of drugs or any individual drug.

• Hydroxocobalamin; usually does not interact with any specific group of drugs or any individual drug.

• Iron dextran Injection; usually does not interact with any specific group of drugs or any individual drug.
Treatment of Iron deficiency anemia Treatment of Iron deficiency anemia Reviewed by gafacom on July 05, 2019 Rating: 5

No comments:

Powered by Blogger.