Iron deficiency anemia treatment

Anemia is a decrease in the number of red blood cells (RBCs), a decrease in die amount of hemoglobin in RBCs, or bodi a decrease in die number of RBCs and hemoglobin. When diere is an insufficient amount of hemoglobin to deliver oxygen to die tissues, anemia exists. There are various types and causes of anemia For example, anemia can be die result of blood loss, excessive destruction of RBCs, inadequate production of RBCs, and deficits in various nutrients, such as in iron deficiency anemia Once the type and cause have been identified, die primary health care provider selects a method of treatment. 

The anemias discussed in this chapter include iron deficiency anemia, anemia in patients witii chronic renal disease pernicious anemia, and anemia resulting from a folic acid deficiency. Table 45-1 defines these anemias. Drugp used in treatment of anemia are summarized in die Summary Drug Table Drugp Used in die Treatment of Anemia. 

Iron salts, such as ferrous sulfate or ferrous gluconate, are used in the treatment of iron deficiency anemia, which occurs when there is a loss of iron that is greater than the available iron stored in the body. Iron preparations act by elevating the serum iron concentration, which replenishes hemoglobin and depleted iron stores. 

Iron dextran is a parenteral iron that is also used for die treatment of iron deficiency anemia It is primarily used when the patient cannot take oral drugs or when the patient experiences gastrointestinal intolerance to oral iron administration. Other iron preparations, both oral and parenteral, used in the treatment of iron deficiency anemia can be found in the Summary Drug Table Dragp Used in the Treatment of Anemia... 

GABRiELLi G B and DE SANDRE G (1995) Excessive tea consumption can inhibit the efficacy of oral iron treatment in iron-deficiency anemia , Haematologica, 80(6), 518-20. 

The initial treatment of iron-deficiency anemia is oral iron therapy with 200 mg of elemental iron daily for those who are able to tolerate the oral route. In order to attain this amount of elemental iron daily, many different iron products and salt forms are available. Table 63-3 lists the various salt forms of oral iron available, the amount of elemental iron in each product, and the approximate daily dose of the salt to attain 200 mg of elemental iron daily. 

Some other examples of free radical formation in various pathologies are discussed below. (Of course, they are only few examples among many others, which can be found in literature.) Mitochondrial diseases are associated with superoxide overproduction [428] and cytochrome c release [429], For example, mitochondrial superoxide production apparently contributes to hippocampal pathology produced by kainate [430]. It has been found that erythrocytes from iron deficiency anemia are more susceptible to oxidative stress than normal cells but have a good capacity for recovery [431]. The beneficial effects of treatment of iron deficiency anemia with iron dextran and iron polymaltose complexes have been shown [432,433]. 

Iron deficiency For the prevention and treatment of iron deficiency and iron deficiency anemias. 

Iron deficiency anemia For the treatment of iron deficiency anemia in patients undergoing chronic hemodialysis who are receiving supplemental erythropoietin therapy. 

Iron deficiency anemia is treated with oral or parenteral iron preparations. Oral iron corrects the anemia just as rapidly and completely as parenteral iron in most cases if iron absorption from the gastrointestinal tract is normal. An exception is the high requirement for iron of patients with advanced chronic kidney disease who are undergoing hemodialysis and treatment with erythropoietin for these patients, parenteral iron administration is preferred. 

Photodiagnosis is a method based on selective excitation of luminescence emitted by a compound (e.g. Zn(PPIX)) accumulated in blood (e.g. in a treatment of iron-deficiency anemia) or cells (e.g. in a treatment of malignant neoplasms, when the photodiagnosis can precede photodynamic therapy). 

The only clinical indication for the use of iron preparations is the treatment or prevention of iron deficiency anemia. Iron deficiency is commonly seen in populations with increased iron... 

Methods for the depolymerization of dextran to uniform fractions of lower molecular weight have led to the use of two dextran fractions that are suitable for parenteral administration.13,30 In the United States, a dextran fraction of MW 70,000 is used as a blood-volume expander. Clinical dextran is used to restore blood volume in the treatment of patients who have either lost considerable amounts of blood or are in shock. A dextran fraction of MW 40,000 is used to improve the flow in capillaries, to prevent or treat vascular occlusion, and to perfuse organs artifically. B-512(F) dextran is completely metabolized141 in man when fractions are administered parentally. Various dextran fractions have been used to prepare numerous derivatives,29 such as the sulfates, and 0-(2-diethylaminoethyl) (DEAE)-dextran, and complexes with various metals. Dextran sulfates have anticoagulant,340 antilipemic,340 and anti-ulcer341 activity. A soluble, iron-dextran complex342 of MW 5000 is used to alleviate iron-deficiency anemia, and a calcium complex332 alleviates hypocalcemia of cattle. 

One of these approaches is the formation of polysaccharide iron complexes (PIC), such as Niferex, a compound used in the treatment of iron deficiency anemia. PICs are formed by neutralization of FeCb-containing carbohydrate solutions with base. Mineral particles of roughly the same size as ferritin cores can be made. These contain iron in an octahedral enviromnent coordinated to oxygen. However, the long-range order of the polynuclear iron core is closer to that of akaganeite rather than ferrihydrite. ... 

An allergic reaction led to early termination of epoetin treatment in one of 26 pregnant women treated with epoetin for iron deficiency anemia (26). 

Sifakis S, Angelakis E, Vardaki E, Koumantaki Y, Matalliotakis I, Koumantakis E. Erythropoietin in the treatment of iron deficiency anemia during pregnancy. Gynecol Obstet Invest 2001 51(3) 150-6. 

In an open, non-comparative trial in 1506 patients, the adverse effects of pirprofen were mainly gastrointestinal, and consisted mostly of epigastric pain. There were single cases of an attack of asthma, iron deficiency anemia, leukopenia, and an increase in serum transaminases to more than 10 times normal (1). In a long-term trial, 9.7% of over 3000 patients stopped treatment because of poor tolerability. The manufacturers decided to discontinue marketing it worldwide, saying that this was a commercial decision (SEDA-16, 111). 

Using a radioiron technique (15), 105 mg of iron as ferrous sulfate embedded in resin to form a tablet was better absorbed when 500 mg of ascorbic acid was incorporated into the preparation as compared with resin-embedded ferrous sulfate or an aqueous solution of ferrous sulfate. In the treatment of iron deficiency anemia, a more rapid repletion of hemoglobin was found when 500-750 mg of supplementary vitamin C was given prior to an oral dose of therapeutic metallic iron (16). 

Treatment Given to correct or control iron-deficiency anemia... 

The serum iron concentration refers to the Fe " bound to serum transferrin and does not include the iron contained in serum as free Hb. The serum iron concentration is decreased in many but not aU patients with iron deficiency anemia and in chronic inflammatory disorders such as acute infection, immunization, and myocardial infarction (Table 31-4). Serum iron concentration diminishes especially in patients who are beginning to respond to specific hemathiic therapy for anemias of other causes such as treatment of pernicious anemia with cyanocobalamin. Acute or recent hemorrhage, including that caused by blood donation, results in low serum iron concentration. Serum iron con-... 

Indication Treatment of iron deficiency anemia in patients undergoing chronic hemodialysis who are receiving supplemental erythropoietin therapy Treatment of patients with documented iron deficiency in whom oral therapy is unsatisfactory or impossible Treatment of iron deficiency anemia in patients undergoing chronic hemodialysis who are receiving supplemental epoetin alfa therapy... 

In iron deficiency anemias, patients often have raised glycosylated hemoglobin values, even rising into the diabetic range, which subside on treatment (B25). Different explanations have been given to account for this phenomenon (M27, S28). 

Ferrous sulfate (20% elemental iron) and ferrous gluconate (11.6% elemental iron) are used in iron deficiency anemia. Extensive numbers of oral preparations are available for the treatment of iron deficiency. In general, the ferrous salts (ferrous sulfate, ferrous gluconate, and ferrous fumerate) are better absorbed than the ferric salts (ferric sulfate). Eerrous calcium citrate is mostly used in patients during pregnancy to provide iron as well as calcium. The parenteral... 

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