Lab Values Oral Iron Oral Iron Products Oral Product Ferrous fumarate Ferrous gluconate Ferrous sulfate PolysaccharideIron Complex Formulations available Tablets Tablets Liquid Tablet Liquid Capsule ID: 1035846
Download Presentation The PPT/PDF document "Anemia Tyler Norris, PharmD Candidate 20..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
1. AnemiaTyler Norris, PharmD Candidate 2022
2. Lab Values
3.
4. Oral Iron
5. Oral Iron ProductsOral ProductFerrous fumarateFerrous gluconateFerrous sulfatePolysaccharide-Iron ComplexFormulations availableTabletsTabletsLiquid | TabletLiquid | CapsuleElemental iron content33% iron/mg of mineral salt10-14% iron/mg of mineral salt20-30% iron/mg of mineral saltN/ANotes-Once daily dosing (compared to previous oral options)-Less constipation/GI issues comparatively
6. IV Iron
7. IV Iron ProductsGeneric (Brand)Ferric carboxymaltose (Injectafer)Ferric gluconate (Ferrlecit)Ferumoxytol (Feraheme)Iron dextran (INFeD)Iron sucrose (Venofer)[Elemental Fe]50 mg/mL12.5 mg/mL30 mg/mL50 mg/mL20 mg/mLDosing<50 kg: 15 mg/kg on day 1; repeat dose after 7 days≥50 kg: 750 mg on day 1; repeat dose after 7 days125 – 250 mg repeated until hematologic parameters/iron requirements met-Single dose of 1020 mgOR-2 doses of 510 mg 3-8 days apart-Single dose of 1000 mgOR-Multiple doses of 100 mgMultiple doses of 100-300 mgTest Does Required?NoNoNoYes;25 mg prior to first doseNoNotesFewer instances of infusion reactions-CI if previous reaction to ANY IV Iron product-Can affect MRI readings for up to 3 months
8. IV Iron Infusion Reactions
9. IV Iron Infusion Reaction: Risk FactorsPrevious infusion reactionFast infusion rateSevere asthma or eczemaSevere respiratory or cardiac diseaseOld ageConcurrent therapy with beta-blockers or ACE inhibitorsPregnancy (1st trimester)Systemic Inflammatory Disease (RA, Lupus, etc.)Anxiety
10. IV Iron Infusion Reactions: TreatmentAVOID: avoid use of antihistamines – can cause hypotension, somnolence, diaphoresis, tachycardia, or mimic anaphylaxisALL IV iron products contraindicated in patients with history of serious hypersensitivity to IV iron product
11. Red Blood Cell Transfusions
12. Iron Overload
13. Erythropoiesis-Stimulating Agents (ESA)Darbepoetin Alfa (Aranesp)Half life 74 hoursAlbumin FreeEpoetin Alfa (Retacrit)Half life 16-67 hours
14. Anemia Diagnostics/Symptoms
15. Pathophysiology Of Anemia
16. Excessive Blood Loss
17. Increased RBC Destruction
18. Examples of Drugs Associated with Hemolysis
19. Intra-RBC Factors
20. Decreased RBC Production
21. Anemia of CKD
22. Differentiation of Types of AnemiaIron Deficiency AnemiaAnemia of Chronic DiseaseAnemia of CKDThalassemiaAnemia of Chronic Disease/InflammationMCV↓Normal*Normal↓↓Ferritin↓Normal/↑Varies-NormalSerum Iron↓↓VariesNormal↓Transferrin↑↓Varies-↓Transferrin %↓↓Varies-↓TIBC↑↓Varies-↓Notes“Burr cells”“Target” cellsAs result of cytokine release, ferritin can be elevated, making lab results less valuable.
23. References