Transcript Iron deficiency Anemia :Deficiency in number of redblood cells or deficiency in total hemoglobin content per unit of blood volum . Anemia can be.

Iron deficiency
Anemia :Deficiency in number of redblood cells or
deficiency in total hemoglobin content per
unit of blood volum .
Anemia can be caused by :-
1- Excessive blood loss
.
2 – Blood
destruction caused by :i-drug therapy.
ii- Infection and toxines .
iii- Defective hemoglobin( thalassemias) .
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3 – Decreased blood formation can be caused by:i- deficiencies of key materials such as :coblamin (VB12), folic acid, iron , pyridoxin ( VB6)
ii- Renal insufficiency .
iii - Bon marrow failiar .
iv – Infections.
Anemia treatment : 1- Blood transfution.
2 – Using the deficient materials necessary for red
blood cells formation.
3 – Treatment the pathological condition causing
the anemia.
4 – Supplemental therapy .
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Iron – deficiency Anemia in Infants :Infant iron stores exhausted due to : 1- Very low iron intake in first few months.
2-High iron needs requird for rapid growrh.
Infant iron stores is about 250 mg . This value
is fond even if the mother is iron
deficient.
This iron store prevents anemia
during the first few
months.
Infants need about 0.9 mg iron daily.
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Iron replacement & supplemental therapy
Drugs used for this purpose : 1- Must be biologically available compounds.
2- Non irritating compounds.
When iron replacement and supplemental therapy
prescribed these points must be taken : 1- The oral rout is the best of choice .
2- Ferrous salts are better absorbed than ferric
salts, but thy have the same side effects .
Ferrous sulphat FeSO4 is the standerd drug used.
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Iron is protein precipetant and can be irritant to
the G.I. tract, so it is usually given after meals.
Iron is bestly absorbed in between meals in
the duodenum .
Official Iron Products
1- Ferrous fumarate :
FeC2H2(CO2)2
M.wt. 169.9
O
CH C
O=C CH
O Fe
O
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It is red-orang to red-brown oderless powder.
Slightly soluble in water.
Very low soluble in alcohol.
It is resistant to oxidation on air exposure
Little conversion to ferric form.
Dissolved in dil. HCl producing fumaric acid.
FeC2H2(CO2) + 2HCl
FeCl2 + C2H2(CO2H)2
Dose : 200 mg tablet( equal to 60 mg iron )
1-3 times daily
USP name : ircon , toleron .
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2- Ferrous gluconate
M.wt. 482.18
Yello-green powder with oder
like burnt sugar.
COO
H C OH
HO C H
H C OH
H C OH
CH2OH
Fe2+.H2O
2
Its solution(1/20conc.) is acidic to litmus.
Soluble in water but insoluble in alcohol.
It has good bioavailability.
Dosage : 300 mg ,3 times / day ( equiv. To 35 mg iron
N.F. Name :Fergon
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3-Ferrous sulphate : FeSO4 ( M.wt.278.)
Blue- green oderless crystals or granules .
It has saline test and efflorescent in dry air
.
Oxidized in moist air producing ferric sulphate
Fe4 [ (OH)2(SO4)5]
Its sol.(1/10 con. ) is acidic to litmus .
It can be irritating for G.I. mucosa due to
astringent action of the soluble ion .
Ferrous sulphate is the drug of choice
.
Dose : 300 mg tablets( equiv. 60 mg iron ) 2-3 times
Syrup,every 1000cc, sucrose825gm,as stabilizing
agent and2.1gm citric acid as an acid buffer .
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4- Iron Dextran injection(USP imferon)
Ferric hydroxide Fe(OH)2 complexed with
dextrane(glucose polymer of low M.wt.)
Its solution has PH 5.2-6.5 for intramuscular
injection .
Used in sever iron deficiency where oral drugs
are not effective
The dose must be carefully measured according
to tables .
Dose : 100 mg iron equivalent
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5- Iron sorbitol injection ( USP : Jectofer)
Acomplex of iron, sorbitol and cetric acid
stabilized with dextrin and sorbitol .
Brown clear liquid PH 7.2-7.9 for intramuscular
injection ,100-200 mg daily
Non – official preparatios : 1- Dextriferron ( Astrafer ) : -
Aquous sol. of ferric chloride complexed with
dextrin , used for I.V. injection only .
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Immidiate reactions of dextriferron : Flushing of face,nausea,headache,vomitting abdominal
pain, hypertention,collapse and severe anaphylactoid
responses.
Delayed effects : fever,chills. And sensation of
in arms and legs . Dose 20-30 mg/daily.
stiffness
2- Ferro cholinate : Ferric iron chelated preparation for pediatric
use. Used as drop, liquid and tablets .
Other preperations include : ferric ammonium citrate.
Ferric cacodylate,FeCl3, Fe2O3,FeCO3, etc.
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