Pharmacotherapy-II
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show | iron def, anemia chronic dz, associated w/ acute blood loss
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Symptoms of acute onset anemia | show 🗑
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show | fatigue, weakness, HA, vertigo, faintness, sensitivity to cold, loss of skin tone pallor
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show | CBC w/ RBC, retic count, FOB
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Nl ranges for Hgb and hematocrit | show 🗑
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Nl MCV | show 🗑
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show | M: 45-160 F: 30-150
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Nl ferritin | show 🗑
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show | M: .5-1.5 F: .5-2.5
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show | Hgb synthesis therefore O2 transport
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show | inadequate dietary intake, inadequate aborption, ↑iron demands, blood loss, list some of each
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What are signs of iron def | show 🗑
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Koilonychias | show 🗑
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show | affects cognitive fxn and achievement
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Lab findings with iron def anemia | show 🗑
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What ↑ absorption on nonheme iron | show 🗑
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What iron is more easily absorbed | show 🗑
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show | milk and tea
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show | find underlying cause, dietary supplements, therapeutic iron preparations oral or paraenteral, transfusions
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show | max in duadnum, rest in small intestine ( don’t want extended release)
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show | 200mg elemental iron/day, in 2-3 doses (best absorbed w/o food or other meds)
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When is iron better tolerated | show 🗑
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MC iron supplementation | show 🗑
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show | GI, discoloration of feces (black), abd pain, heartburn, constipation, N/V
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Absecence of AE’s may indicate what | show 🗑
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show | take iron w/ meals (↓daily dose to 110-120mg elemental Fe)
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Monitoring of iron supplementation | show 🗑
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show | nonadhearence, misdiagnosis, malabsorption, blood loss, anemia-inducing dz states
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What is the gold standard for parenteral iron supplementation | show 🗑
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show | arthralgias, myalgias,flushing, malaise, fever, allergic rxns (rarely anaphylaxis)
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What should we do prior to giving full iron dextrose dose | show 🗑
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show | water soluble vitamin, obtained by ingestion of meat and dairy products,
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show | needed for DNA synthesis, metabolic rxns w/ folic acid,
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show | 2-2.6mg
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show | inadequate intake, ↓ absorption, inadequate utilization
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s/s of B12 def | show 🗑
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lab findings of B12 def | show 🗑
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show | Vit B12 def d/t intrinsic factor def
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show | oral (1-2mg), parenteral:1000mcg q week , nasal spray: do not administer within 1 hr hot food/beverage
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monitoring of B12 def tx | show 🗑
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what may be greater during B12 initiation | show 🗑
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AE’s ofB12 tx | show 🗑
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Where can we find folic acid | show 🗑
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What is folic acid | show 🗑
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What are folate antagonists | show 🗑
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show | inducers: phenytoin, phenobarbital, primidone
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Sxs of folic acid def | show 🗑
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show | 1-5mg po qdx4m
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What is pre contraception for folic acid | show 🗑
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show | within 2m
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What is the anemia mechanism with anemia of chronic dz | show 🗑
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show | may inhibit production or action of erythropoietin or inhibit RBC production
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show | serum iron ↓, ferritin nl or ↑, iron binding capacity nl or ↓
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show | tx underlyin d/o erythropoietin stimulating agents,
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AE’s of erthyropoeitin | show 🗑
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