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20 Cards in this Set
- Front
- Back
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most common cause of iron deficiency in premenopausal women is?
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menstrual blood loss
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most common cause of iron deficiency in postmenopausal women is?
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occult blood loss through GI bleeding
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ferrous sulfate tablets
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most common oral iron supplement--immediate release/generic preparation
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iron dextran (LMW and HMW)
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parenteral iron supplement--LMW and HMW are not clinically interchangeable
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Ferrous sulfate tablets
1.dose 2.ADR |
1.-adult daily dose 325mg(5gr) po tid between meals
2.-constipation,dark stool, nausea, epigastric pain |
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DI of ferrous sulfate:
1.aluminum-magnesium hydroxide antacids 2.antacids or histamine-2 rec antagonists 3.tetracycline |
1. reacts to form insoluble substances, take iron 1hr before or 3hr after
2.increase gastric pH and decreased solubility of iron salts 3. absorption greatly decreased=>chelation rxn |
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ferrous sulfate tablets dispensing info
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-darkens stool
-best taken on an empty stomach -avoid taking before bed due to epigastric effects |
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iron dextran black box warning
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-potentially fatal hypersensitivity rxn/test dose required
-higher incidence with HMW -delayed rxns of up to 24-48 hrs possible |
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injection recommendations for iron dextran
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-UOQ of buttock
-deep muscle injectionwith Z-track technique to avoui leakage into SC and staining |
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major causative factors of Folic Acid deficiency Anemia
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-alcohlolism due to poor nutrition
-condition of rapid cell turnover(malignancy) -malabsorption syndromes |
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contraindication of tx of pernicious anemia where B12 is deficient
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-lg doses of folate can reverse hematological abnormalities but do not correct the neurologic damage
-must completely differentiate between folate and B12 def anemia before fofolate therapy is started |
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If folic acid deficiency is caused by a DHFR inhibitor, then treatment is?
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leucovorin calcium (folinic acid)
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DHFR
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dihydrofolate reductase--enzyme needed to convert dietary or supplemental folic acid to active folate forms needed for DNA synthesis
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DHFR inhibitor
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inhibits the conversion of folate acid into active forms
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leucovirin calcium
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form of folic acid that does not require DHFR for conversion to active form, therefore bypassing the DHFR inhibitor
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Epoeitin alfa
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recombinant glycoprotein that has the same actions as erythropoietin
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Epoeitin alfa indications
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-anemia assoc with CKD
-chemo-induced anemia -anemia related to zidovudine (ZDV/Retrovir) therapy in HIV pts |
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Epoetin alfa contraindicated in?
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uncontrolled HTN
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DI of oral iron supplements and epoetin alfa
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-failure of oral iron supplements to maintain adequate iron stores in hemodialysis pts
-many CKD and almost all hemodialysis pts require parenteral supplements |
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Black box warning for ESA(erythropoietin stimulating agents)
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FDA recommends target Hgb of 10-12g/dl and not >12g/dl; pts have increased risk of serious CV events and death if >12g/dl
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