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Medicine

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Hematology

Question
14 out of 16
 

Which of the following is true about oral therapy for iron deficiency anemia: (PGI May 2009)



A In 300 mg elemental iron given 100 mg get absorbed

B Reticulocytosis appears in one to 2 weeks and then peaks in 3-4 weeks

C Hemoglobin levels are usually corrected in six months of initiating therapy

D Decrease in absorption with improvement of symptoms

E Stop the Rx after normalizing the Hb

Ans. D

Decrease in absorption with improvement of symptoms

Management

1. Iron replacement by ferrous sulphate Continue until hemoglobin is normal and for 6 –8 months to replenish stores.(MCQ)

2. Parenteral iron therapy: It is given for those who are unable to absorb iron from the GI tract or to those who have intolerance to oral iron.

3. 100 mg of iron (IM) are required to increase the hemoglobin level by 4% but the total dose of iron should not exceed 2.5 gm.

Iron Requirement

The amount of iron needed by an individual patient is calculated by the following formula:

Body weight (kg) x 2.3 x (15–patient's hemoglobin, g/dL) + 500 or 1000 mg (for stores).

1. Total dose = Hb deficit (gm/dl) X lean body weight (lb) + 1000 mg of iron needed for storage.

2. Each 2 ml of iron dextran contains 100 mg of iron.

3. 7 days of oral therapy raises Hb by 1 gm%

4. Parenteral iron (100 mg), raises Hb by 4%

5. If the Hb deficit is 7 gm, oral iron replacement should be continued for at least 7 weeks; Therapy should be continued For 4 to 6 months for replacing iron stores.

6. Newer iron preparation for parentral use

a. IV route – sodium ferric gluconate, iron sucrose

b. IM route – Iron dextran, iron sorbitol citrate

Extra Edge: Oral therapy for iron deficiency anemia

1. A dose of 300mg of elemental iron is given per day in divided doses

2. 300mg of elemental iron gives about 50mg of absorbed iron per day (and not 200 mg of absorbed iron)

3. Typically the reticulocyte count should begin to increase in 4-7 days after initiation of therapy and peak at 1½ weeks (not at 3-4 weeks)

4. Typically the Hb levels should be fully corrected within 1 month of initiating therapy in the absence of continuing blood loss (and not after six months).

5. Treatment should not be stopped after normalizing of Hb, but continued for an additional 4 to 6 months to replenish body iron stores.

Extra Edge:

Male

Female

1. Iron present in diet

10-20mg

10-20mg

2. % of iron absorbed in normal state

6-10%

10-12%

3. % of iron absorbed in iron def anaemia

20%

20%

4. Max % of iron intestine can absorbed

20%

20%

Hematology Flashcard List

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