Iron And Iron Deficiency Anaemia

Question 1

What is IDA - Iron deficiency anaemia

Answer 1

Fewer red blood cells than normal OR
Less haemoglobin than normal

So,less oxygen carried around the blood stream, lack of iron is the most common cause

• iron is required to make haemoglobin, anaemia can be caused by the last of iron - this is called iron deficiency anaemia

Question 2

Iron deficiency,treatment and prophylaxis

Answer 2

• iron should only be given in the presence of a demonstratable deficiency state
• exclude any serious underlying causes of anaemia before actually selling or starting an iron treatment - these conditions could be anything like - gastric erosion, Gi cancer

Question 3

What conditions require Iron prophylaxis

Answer 3

• iron should be given:

Malabsorption
Menorrhagia
Pregnancy
After subtotal or total gastrectomy
Haemodialysis patients
Management of low birth weight infants such as preterm neonates

Question 4

Oral Iron

Answer 4

• iron salts should be given by mouth (oral route)
• there is very little difference between iron salts
• choice of preparation is dependent in the side effects and the cost
• oral dose elemental iron for iron defence anaemia should be 100mg-200mg daily - usually dried ferrous suphate
• ferrous sulphate may be effective for prophylaxis in iron deficiency anaemia

Question 5

Different iron salts

Answer 5

Ferrous fumerate 210mg - 65mg of iron
Ferrous gluconate 300mg - 35 of iron
Ferrous sulfate 300mg - 60mg
Ferrous sulfate dried 200mg - 65mg

Question 6

Compound preparations

Answer 6

Contains folic acid and iron together

Used in pregnancy in women who are at high risk of developing iron and folic acid deficiency (400mcg)

Different from folic acid used in prevention of neural tube defects 5mg

Folic acid dose in these preparations too small to treat megoblastic anaemia
- some preparations contain ascorbic acid (C) to aid the iron absorption

Question 7

Modified release preps

Answer 7

Licensed OD
But, have no therapeutic advantage so we don’t really use it

Question 8

PARENTERAL IRON - examples

Answer 8

Examples
- iron dextran
- iron sucrose
- ferric carboxymaltose
- Iron isomaltoside 1000

Question 9

When is it given

Answer 9

• oral therapy is unsuccessful
• patient does not take iron reliably
• continuing to lose blood
• malabsorption
• chemotherapy induced anaemia
• haemodialysis patients (require iron by IV route)

Question 10

SYMPTOMS OF Deficiency

Answer 10

-Tiredness
- struggling to concentrate
-memory problems
- reduced ability to exercise
- hair losing its condition/possible hair loss
- nails becoming brittle - breaking and splitting easily. They may even change shape - concave or spoon shape and may develop ridges
- cuts and grazes taking a long time to heal
- sores at the corners of the mouth

Question 11

Side effects of iron

Answer 11

• black tarry stool
• constipation
• diarrhoea
• Gi irritation
• Nausea
• Epigastric pain
• MR can exacerbate diarrhoea in pts with IBS

Question 12

Counselling

Answer 12

• take after food to reduced side effects
• best absorbed on an empty stomach however
• may discolour stools