Flashcards in Pharm 26 Objectives Deck (56)
What is the average daily maximum elemental iron absorption in both mg and %?
Mg: 3 – 4 mg/ day
%: 5 – 20% daily intake
Absorption of iron increases when?
- erythropoietic activity is high
- iron stores are depleted and iron absorption processes are intact
When does the iron absorption process become saturated?
The larger the dose of iron the more mg of iron is absorbed BUT the process becomes saturated and a smaller % of the dose is actually absorbed.
What is the primary factor that determines daily iron requirements?
Rate of erythrocyte production
Why it is important to consider the elemental iron dose within an oral iron product?
Elemental iron is the total amount of iron in the supplement available for absorption in the body. Each type of iron preparations has different percent of elemental iron so it is important to be aware of what iron preparation you are taking and what elemental iron % is listed to avoid iron toxicity
What is the RDA of iron in men and women?
- Men: 8-10 mg/day
- Women: 15mg/day
What dose of iron is used to treat iron deficiency anemia?
- 100 to 200mg/day
What is dose of Ferrous sulfate for IDA?
65mg elemental iron per 325mg tab
- 2 tabs/ day = 130 mg
- 3 tabs/day = 195mg
What is dose of Ferrous gluconate for IDA?
38mg elemental iron per 324mg tab
- 3 tabs/day= 114mg
What dose of an iron supplement is recommended to prevent IDA from occurring again.
27mg to 150mg
How much iron is contained in a prenatal vitamin?
List several foods or food groups that are naturally rich sources of iron and a cooking device (possibly) useful for preventing iron deficiency.
- Liver, egg yolk, brewer’s yeast, wheat germ, muscle meats, fish, fowl, cereal grains, beans, and green leafy vegetables
- Cook with cast-iron pan
List three general reasons that oral iron supplementation is preferred over the use of IV iron
- No need for test dose or observation period/safety consideration w/ oral
- Less toxicity risks
-Easily assessable and less expensive than IV
What components are needed to calculate an IV dose of iron dextran?
- Observed Hb
- Normal adult Hb
- Lean body weight
What is the procedure/safety considerations for administering IV dextran for the first time?
- Test dose: 0.5 mL IV over 30 seconds for 5 minutes
- 1 hr after test dose administer the balance of the dose if no hypersensitivity reaction occurs
- Observation includes: aware, trained personnel w/ resuscitation equipment and epinephrine on hand
What is the hormone that stimulates and commits the less differentiated blood cell progenitors to the RBC pathway?
What are the pharmacologic congeners that stimulates and commits the less differentiated blood cell progenitors to the RBC pathway?
- Epoetin alfa
- Epoetin beta
What is the MOA of ESAs/EPOs?
Inhibit apoptosis of erythroblast precursors which increases red blood cell mass
What are some clinical utilizations of ESAs/EPOs?
- Anemia associated with chronic renal failure
-Chemotherapy induced anemia
-HIV infected pts taking zidovudine
-Anemia in pts facing surgery
RBC production is stimulated by?
WBC production is stimulated by?
Platelet production is stimulated by?
What is the black box warning of ESAs/EPOs?
- CKD greater risk for death, CV rxns, and stroke when administered ESAs to target Hb levels of 11g/dL and above.
- Used in cancer pts: shortened overall survival and/or increased risk of tumor progression or reoccurrence.
Why we don’t we use folic acid for all patients with megaloblastic anemia?
- It can mask a vitamin B12 deficiency.
- Folic acid will reverse the disruption of hemopoiesis, but will not improve the neurologic deficits and will allow it to progress
What is the iron dose that is recommenced during pregnancy?
What is the folate acid dose that is recommenced during pregnancy?
- At least 400 mcg/day in addition to any dietary intake
- Parental vitamins 800 mcg (OTC) to 1000 mcg (rx)
What trimester is critical for folate acid supplementation?
Name the preferred Rx product for rescue with methotrexate.
What is a cobalamin replacement product for megaloblastic anemia due to vitamin B-12 deficiency.
Cyanocobalamin (MC'ly used) or Methylcobalamin