anaemias Flashcards
(9 cards)
sickle cell anaemia - imp points
deformed less flexible RBCs
acute complication - sickle cell crisis - restricted blood supply to organs
- hospitalisation - IV fluids, analgesia, treat any infections as pt will be susceptible
if pt develops haemolytic anaemia - RBC destruction - increase folate (folic acid supplementation)
hydroxycarbamide reduces freq of painful crisis and reduces transfusion requirements - prevents future ones
pneumococcal, haemophilus influenza B, annual influenza, hep B vaccine + lifelong prophylactic penicillin - reduce risk of infection
G6PD deficiency
glucose 6 phosphate dehydrogenase
common in african and asian
more common in males
susceptible to developing acute haemolytic anaemia - esp with fava beans
drugs with definite risk of haemolysis in most G6PD pts:
- dapsone
- fluoroquinolones
- nitrofurantoin
- quinolones
- sulphonamides
drugs with possible risk:
- aspirin
- chloroquine
- menadione
- quinine
- sulphonylurea
when can iron be given prophylactically?
rule out - gastric erosion or GI cancer
can give iron prophylactically:
- malabsorption
- menorrhagia
- pregnancy
- haemodialysis pts
- low birth weight infants - preterm neonates
iron imp points
ferrous fumurate, gluconate, sulfate, sulfate(dried)
daily elemental iron 60-70 mg
- usually taken as ferrous sulfate (dried)
- MR reduces absorption
SE’s: constipation or diarrhoea, black tarry stools
stop iron if C.Diff
take with Vit C + before food for best absorption
take after food to reduce SE’s
when Hb in normal range - continue for 3 more months
toxicity treated with desferrioxamine
parenteral iron imp points
iron dextran, iron sucrose, ferric carboxymaltose, ferric derisomaltose
used when:
- oral therapy not tolerated
- chemotherapy-induced anaemia
- chronic renal failure in haemodialysis
MHRA - serious hypersensitivity reactions with IV iron
- appropriately trained staff and resus must be available
- monitor for at least 30 mins after each administration
megoblastic anaemia
can be eithet b12 deficiency or folate deficiency
first step - find out cause
if emergency and can’t determine cause - give BOTH
- if only give folate - may cause neuropathy
if vit B12 deficiency
- give hydroxycobolamin (b12) IM
- 1mg three times a week for 2 weeks then 1mg every 2-3 months maintenance
if folate deficiency
- daily folic acid 5mg supplementation for 4 months
folic acid imp points
2 doses:
regular pregnancy with low risk of NTDs: 400 mcg OD (OTC) - from before conception to week 12 of pregnancy
risk of NTDs: 5mg OD (rx’d) from before conception to week 12
risk of NTDs:
- smoking
- sickle cell anaemia
- diabetes
- obesity
- use of anti-epileptic drugs
- use of anti-malarial drugs
aplastic and renal anaemias treatment
IV horse antithymocyte globulin + ciclosporin - immunosuppressant treatment
prednisiolone - prevents adverse effects of antithymocyte globulin
pyridoxine - licensed for sideroblastic anaemia
- body has enough iron but cannot use it to make Hb
erythropoietin deficiency anaemia
epoetins - treats anaemias associated with erythropoietin deficiency in chronic renal failure
epoetin beta - prevention of anaemia in pre term neonates of low birth weight
darbepoetin alfa - longer half life and administered less frequently than epoetin
