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  • Treatment of Nutritional Anemias

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    Posan Samser Limbu
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    This document summarizes treatments for iron deficiency anemia, including oral iron therapy, parenteral iron therapy, folic acid supplementation, vitamin B12 supplementation, and blood transfusions. It outlines recommended dosages and administration for each treatment and notes potential side effects. The key points covered are oral iron preparations and dosages, indications for parenteral iron therapy, calculating iron needs, side effects of parenteral iron, and guidelines for folic acid and B12 supplementation. The resource person and references are also listed.

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    This document summarizes treatments for iron deficiency anemia, including oral iron therapy, parenteral iron therapy, folic acid supplementation, vitamin B12 supplementation, and blood transfusions. It outlines recommended dosages and administration for each treatment and notes potential side effects. The key points covered are oral iron preparations and dosages, indications for parenteral iron therapy, calculating iron needs, side effects of parenteral iron, and guidelines for folic acid and B12 supplementation. The resource person and references are also listed.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
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    44 views12 pages

    Treatment of Nutritional Anemias

    Uploaded by

    Posan Samser Limbu
    This document summarizes treatments for iron deficiency anemia, including oral iron therapy, parenteral iron therapy, folic acid supplementation, vitamin B12 supplementation, and blood transfusions. It outlines recommended dosages and administration for each treatment and notes potential side effects. The key points covered are oral iron preparations and dosages, indications for parenteral iron therapy, calculating iron needs, side effects of parenteral iron, and guidelines for folic acid and B12 supplementation. The resource person and references are also listed.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 12

    Y 

       
     

    Posan S Limbu

    Resource Person: Dr. Nabin Pandey


    Y 
    

    Raw materials

    Factory

    Market
    Supply Line
     
    Oral Iron Therapy
    moal ± repair anemia ± replenish stores

    200-300mg/d elemental iron for 6m ± 1 yr

    Iron Preparations
    Ferrous sulfate ± 325mg (65mg), 195mg (39mg)
    Extended release ± 525mg (105mg)
    Ferrous Fumarate ± 325 mg (107mg), 195 mg (64mg)
    Ferrous gluconate ± 325mg (39mg)
    Polysachharide Iron 15mg(150mg), 50mg (50mg)
     
    Õ áide effects of Oral Iron Therapy
    Õ mastrointestinal side effects
    Nausea, Vomiting, Abdominal discomfort,
    Constipation

    Use of small doses of iron or iron preparations with


    delayed release may help

    If compliance is a major issue and patient is not


    responding ± switch to parenteral iron therapy
     
    Õ Parenteral Iron Therapy
    Indicated for
    1. Patients who are unable to tolerate oral iron
    therapy
    2. Needs are relatively acute
    3. Require iron on an ongoing basis, usually due
    to persistent gastrointestinal blood loss
     
    Õ Amount of iron needed by an individual patient

    Õ ody wt. (kg) × 2.3 × (Hb Deficit) + Storage


    (15-Pt. Hb (g/dl) (500 or 1000mg)

    One shot Multi shot


     
    áide effects of Parenteral Iron Therapy
    Õ Dose related ± arthralgias, skin rash, and low-grade
    fever ± dies not preclude the further use of parenteral
    iron

    ANAPHYLAXIS
    - Not seen with newer preparations
    - eware ± h/o multiple allergies or a prior allergic
    reaction to dextran
    - If chest pain, wheezing, a fall in blood pressure, or other
    systemic manifestations occur ± immediate interruption
    of infusion
    ë   
    Õ 1mg/d oral
    Õ 5mg/d oral for malabsorption

    Õ Patients with a continuously increased


    requirement (such as patients with hemolytic
    anemia) or those with malabsorption or chronic
    malnutrition should continue to receive oral folic
    acid indefinitely
    `  
    Õ Parenteral
    Õ IM cyanocobalamin 1000 µg per week for 8
    weeks (or 6 -1000 µg IM injections at 3-7 day
    intervals)
    Õ Followed by - 1000 µg per month for the rest of
    the patient¶s life (or 1000 µg IM inj. Every 3m)

    Oral crstalline 12 2mg/day for those with


    deficient intake
    Ú Y 
     
    One unit of packed red cells increases Hb level by 1g/dl
    Corrects anemia and also provides iron
    Iron chelation therapy (with desferrioxamine) required to
    prevent hemosiderosis for pts. who have received > 100
    units of Packed R Cs

    Indications
    1. Symptomatic (up to 8g/dl tolerated by individuals
    without cardiovascular or pulmonary disease)
    2. Cardiovascular instability (Hb levels need to be kept
    above 11g/dl)
    3.Continued and excessive blood loss from whatever
    source (eg. acute blood loss > 25 % blood volume)
    — 
    Õ Harrison¶s Principles of Internal Medicine. 16th
    and 17th editions
    Y 

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