Anemia Flashcards
(27 cards)
What is Anemia?
- a decrease in RBC, Hgb, Hct
What is Hemoglobin?
- Iron rich protein in RBC that carries oxygen from lungs to tissues
What is Hematocrit?
- Precent of RBC volume compared to total blood volume
What are Reticulocytes?
- Immature RBC from the bone marrow that takes up Hgb and Iron
What are some of the symptoms of anemia?
- Fatigue, weakness, SOB, exercise intolerance, headache, dizziness, and/or pallor
What is a common symptom for Iron deficiency anemia?
- Glossitis [inflamed tongue], Spoon Shaped Nails, Pica [eating non-foods]
What are common symptoms of B12 deficiency anemia?
- Glossitis and peripheral neuropathy
What is Mean Corpuscular Volume (MCV)?
- size or average volume of RBC
What does a low MCV mean?
- Microcytic anemia
- MCV < 80
- Normally mean iron deficiency
What does a noraml MCV mean?
- MCV 80 - 100
- Noramlly means blood loss, CKD, bone marrow failure
What does a high MCV mean?
- Marcocytic
- MCV > 100
- Normally caused by vit B12 or folate deficiency
What are some of the causes for iron deficiency aneima?
- Low iron intake (vegan diet)
- Blood loss (heavy menses, PUD)
- Decrease iron absoprtion (high gastirc pH, GI disorders)
- Increased iron requirements (pregnant)
What is the way that we assess and treat iron deficiecny anemia?
- Assess (labs): decreased hgb & MCV, increased TIBC
Treat: 1 iron tab daily or everyother day on empty stomach (avoid H2RAs and PPIs; separate from Antacids)
What are some of the oral Iron products that are used?
- Ferrous Sulfate (325 mg [65 mg elemental iron])
- Ferrous Furarate (324 mg [106 mg elemental iron])
- Ferrous Gluconate (324 mg [38 mg elemental iron])
- Carbonyl Iron
- Polysaccharide Iron complex
- Ferric Maltol (ACCRUFeR)
what are the boxed warnings for the oral iron products?
- accidental overdose = fatal poisoning in kids
look like candy
what are some side effects of the oral iron products?
- Constipation
- Dark and Tarry stols
- Nausea
- Stomach Upset
What are some drug interactions for the oral iron products?
- PPI, H2RAs, Antacids = decreased iron absorption & increase gastric pH
- Vit C = increase iron absoprtion
- Quinolone/Tetracyclines = take iron 2H before or 4-8H after
- Bisphosphonates = take iron 30 - 60 mins after
- Levothyroxine = separate iron by 4H
What type of patient is IV iron restricted too?
- CKD on Hemodialysis and/or getting ESAs
- Unable to tolerate Oral iron
- Severe anemia (Hgb < 7)
- Patients that wont accept RBC transfusions (religious reasons)
What are some of the IV Iron products?
- Iron surcose (venofer)
- Ferunoxytol (Feraheme)
- Iron dextran complex (INFeD0
- Ferric Gluconate (Ferriecit)
- Ferric Carboxymaltose
- Ferric derisomaltose
What are some boxed warnings for the IV iron products?
- Iron Dextran & Ferumoxytol: serious and sometime fatal anaphylactic reactions
- Iron Dextron: test dose before (fatal reactions)
What are some of the causes for macrocytic anemia?
VIT B12 and FOLATE
- Pernicious anemia (most common) - autoimmune condition leading to poor B12 absorption
- Alcohol use disorders
- Low intake of Vit B12
- Long term use of metformin, H2RAs, PPIs
What are some of the treatments for vitamin B12 and folate deficiencies?
- Cyanocobalamin (Vitamin B12) Injections
- Folic Acid (Vitamin B9), Folate
What is erythropoietin (EPO)?
- hormone produced by the kidneys to stimulate the bone marrow to make RBC
What are the two ESAs that are used>
- Epoetin Alfa (Epogen)
- Darbepoetin Alfa (Aranesp)
