Iron preparations

The AET was used at standard tests of numerous structural materials, above all steels and cast iron, prepared are ceramic samples. Part of tested samples had qjecial sur ce layer treatments by laser, plasma nitridation and similar. Effect of special surface treatment the authors published already earlier [5,6]. In this contribution are summed up typical courses of basic dependencies, measured by the AET at contact loading. 

There is an increased risk of toxicity of MTX when administered with the NSAIDs, salicylates, oral antidiabetic drugs, phenytoin, tetracycline, and probenecid. There is an additive bone marrow depressant effect when administered with other drug known to depress the bone marrow or with radiation therapy. There is an increased risk for nephrotoxicity when MTX is administered with other drug that cause nephrotoxicity. When penicillamine is administered with digoxin, decreased blood levels of digoxin may occur. There is a decreased absorption of penicillamine when the dmg is administered with food, iron preparations, and antacids. 

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... 

MANAGING CONSTIPATION. Constipation may be a problem when a patient is taking oral iron preparations. The nurse instructs the patient to increase fluid intake to 10 to 12 glasses of water per day (if the condition permits), eat a diet high in fiber, and increase activity. An active lifestyle and regular exercise (if condition permits) help to decrease tiie constipating effects of iron. If... 

Mix the liquid iron preparation with water or juice and drink through a straw to prevent staining of the teeth. 

Calcium carbonate or magnesium hydroxide antacids may decrease the effectiveness of the digestive enzymes. When administered concurrently with an iron preparation, the digestive enzymes decrease the absorption of oral iron preparations. 

Compare and contrast the various oral and parenteral iron preparations. 

A wider problem exists with the possible role of liquid medications in dental caries formation [63], The extent of acid production in the oral cavity is closely related to caries formation. In a study of liquid medication, investigators have observed that medications with sucrose concentrations higher than 15% were able to significantly lower pH there was an inverse relation between sucrose content and a decrease in oral cavity pH [64], In a comparison of sorbitol and sucrose-sweetened liquid iron preparations, only sucrose-containing products produced a significant decrease in oral cavity pH [65],... 

Available parenteral iron preparations have similar efficacy but different pharmacologic, pharmacokinetic, and safety profiles (Table 33-5). The newer products, sodium ferric gluconate and iron sucrose, appear to be better tolerated than iron dextran. 

IV iron preparations have different pharmacokinetic profiles, which do not correlate with pharmacodynamic effect. 

The average adult body contains approximately 4 g of iron, of which roughly two-thirds exists in the form of hemoglobin. Treatment of certain types of anemias usually consists of dietary supplementation or the administration of therapeutic iron preparations by oral and parenteral routes. Iron is often administered by i.m. as iron-dextran complex which is ferric hydroxide and dextran containing 50 mg of iron per milliliter. 

Adverse effects. The frequent gastrointestinal complaints (epigastric pain, diarrhea, constipation) necessitate intake of iron preparations with or after meals, although absorption is higher from the empty stomach. 

Drug interactions involving iron sucrose have not been studied. However, like other parenteral iron preparations, iron sucrose may be expected to reduce the absorption of concomitantly administered oral iron preparations. Do not administer concomitantly with oral iron preparations. 

Oral Iron preparations Coadministration of parenteral iron preparations may reduce absorption of oral iron preparations. 

The use of iron preparations of the highest obtainable purity (both commercial and laboratory preparations) as starting materials. Principally employed were Ferrum reductum, Kahlbaum, and later, as an ultra pure material Iron Kahlbaum (cost of 1 kg. about 80.00). 

Gastric acid and ascorbic acid facilitate the absorption of iron. Therefore, bioavailability of iron ingested with food is considerably decreased and also enteric-coated iron preparations are absorbed to a lesser extend. Fixed combinations with ascorbic acid increase the absorption of iron by at least 30%. However such increased uptake seems to have little advantage over a modest increase of dose. 

Adverse effects consist mainly of gastrointestinal intolerance such as nausea, epigastric pain and diarrhea and, especially in the elderly constipation with continued therapy. All ferrous salts may cause a black coloration of the faeces. Children are particularly susceptible to potentially lethal iron intoxications. Oral iron preparations should not be administered concurrently with tetracyclines as mutual interference with absorption will occur. 

I Brand Name(s) (ferrous sulfate) Fer-In-Sol, Fer-Iron, Slow-Fe Chemical Class Iron preparation... 

Drink liquid iron preparations in water or juice and through a straw to prevent tooth stains... 

Table 6.2.1 Classification for iron preparations. Ferrous sulphate (Flydrated salt 20% iron, exsiccated salt 30% iron FERSOLATE). 200-600 mg/day ...

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. 

A wide variety of oral iron preparations is available. Because ferrous iron is most efficiently absorbed, only ferrous salts should be used. Ferrous sulfate, ferrous gluconate, and ferrous fumarate are all effective and inexpensive and are recommended for the treatment of most patients. 

Table 33-3 Some Commonly Used Oral Iron Preparations. ...

Sodium ferric gluconate complex and iron-sucrose complex are alternative parenteral iron preparations. These agents can be given only by the intravenous route. They appear to be less likely than high-molecular-weight iron dextran to cause hypersensitivity reactions. 

Ferrous gluconate and ferrous fumarate Ora iron preparations ... 

Oral iron preparations nists Receptor Antagonists... 

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