Daily requirement of Elemental Iron?
150-200 mg
Which patient population requires the highest amount of iron intake?
Pregnant women
How long will IDA treatment occur?
3-6 months
Main side effect of iron?
Constipation
What supplement can be administered with iron to reduce GI side
effects and improve absorption?
Vitamin C
Should iron be taken with food?
NO
(at least 1 hour
before meals; take with water (not milk or tea)
Side effects of iron:
constipation nausea/ abdominal pain
discoloration of feces heartburn
Can antacids be taken with iron?
If a patient must take antacids (ex: Tums), you must separate the
doses by at least
2 hours
When would IV
iron therapy be considered?
When hemoglobin in
LESS THAN 9
Iron
Dextran limitation?
Black Box
Warning for causing anaphylactic reactions
If a patient is to receive IV iron
therapy, how much should they receive?
1 gram
Iron
overload should be avoided since it can cause?
Liver failure
When should RBC
transfusion be considered?
When a patient's hemoglobin is extremely low AND they are
experiencing symptoms of anemia
MCV is greater than 100
Vitamin B-12 deficiency Folate deficiency
If
MMA (methylmalonic acid) is
increased, this is an indicator of...???
Vitamin B-12
deficiency
Treatment of vitamin B-12 deficiency?
Cyanocobalamin
Oral: 1-2 mg PO daily
Vitamin B-12 deficiency can be found in?
vegetarians chronic alcoholism
Folate deficiency anemia can be found in?
poor diet patients chronic alcoholism
Folate
deficiency treatment?
Folic acid 1 mg PO daily
Which laboratory test is elevated in B-12 and not folate?
MMA
Treatment of blood loss:
packaged RBC
Treatment of iron deficiency anemia:
ferrous sulfate 325 mg PO TID
Treatment of vitamin b-12 deficiency:
cyanocobalamin 1000 mcg PO daily
Treatment of folate deficiency:
folic acid 1 mg PO daily
Symptoms of vitamin b-12 deficiency:
burning sensation of the tongue neuropathy
Symptoms of iron deficiency:
pica (eating dirt) pagophagia (eating ice)
Symptoms of folate deficiency:
irritability memory impairment
depression
Chronic signs/symptoms:
fatigue weakness pallor
Acute signs/symptoms:
dizziness tachycardia SOB
Monitoring for folic acid:
malaise flushing bronchospasm
Monitoring for packaged RBC:
hypersensitivity
Monitoring for Iron Dextran:
hypersensitivity
Monitoring for cyanocobalamin:
headache nausea rhinitis