Iron Administration in Chronic Renal Failure
32 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which administration of iron is typically utilized for patients with chronic renal failure?

  • Iron-sucrose intravenously (correct)
  • Iron chelators intragastrically
  • Ferrous fumarate orally
  • Ferrous sulfate orally

    • What is a potential effect of acute iron toxicity?

  • Nausea leading to appetite enhancement
  • Increased production of erythropoietin
  • Severe necrotising gastritis (correct)
  • Reduced absorption in the gastrointestinal tract

    • Which best describes the primary function of desferrioxamine?

  • Promote iron absorption in the gut
  • Increase folate levels in the bloodstream
  • Stimulate the production of red blood cells
  • Bind to iron to prevent its absorption (correct)

    • In which condition is it unlikely for patients to produce adequate erythropoietin?

    <p>Chronic renal disease (B)</p> Signup and view all the answers

    What is one possible adverse reaction to parenteral iron administration?

    <p>Anaphylactic reactions (B)</p> Signup and view all the answers

    Which condition is most associated with chronic iron toxicity?

    <p>Thalassaemias (B)</p> Signup and view all the answers

    Which dietary source is considered rich in folate?

    <p>Liver and green vegetables (C)</p> Signup and view all the answers

    What is a common symptom associated with oral iron administration?

    <p>Abdominal cramps (C)</p> Signup and view all the answers

    What is the primary definition of anaemia?

    <p>A clinical condition with a decrease in red blood cells. (C)</p> Signup and view all the answers

    Which of the following is NOT a type of anaemia mentioned?

    <p>Isolated thrombocytopenic anaemia (B)</p> Signup and view all the answers

    Which symptom is associated with severe cases of anaemia?

    <p>Tachycardia (B)</p> Signup and view all the answers

    What is the primary action of haematinic agents?

    <p>Promote the formation of red blood cells. (B)</p> Signup and view all the answers

    Which nutrient is essential for the treatment of macrocytic anaemia?

    <p>Vitamin B12 (A)</p> Signup and view all the answers

    What is the threshold hemoglobin level for diagnosing anaemia in women?

    <p>12 g/dL (C)</p> Signup and view all the answers

    Which neurological symptom may indicate severe B12 deficiency-related anaemia?

    <p>Ataxia (C)</p> Signup and view all the answers

    Which of the following is a commonly used haematinic agent?

    <p>Folic acid (D)</p> Signup and view all the answers

    What is a indicated use of erythropoietin in clinical settings?

    <p>Anemia during chemotherapy for cancer (B)</p> Signup and view all the answers

    Which condition must NOT be present before starting treatment with erythropoietin?

    <p>Iron deficiency (A)</p> Signup and view all the answers

    What is a common adverse reaction associated with erythropoietin treatment?

    <p>Hypertension (A)</p> Signup and view all the answers

    Granulocyte colony-stimulating factors are primarily used to manage which of the following conditions?

    <p>Neutropenia caused by cytotoxic drugs (C)</p> Signup and view all the answers

    Which of these is NOT a genetic cause of hemolytic anemia?

    <p>Aplastic anemia (A)</p> Signup and view all the answers

    What role do thromboietin and its agonists play in treatment?

    <p>Enhance platelet production (B)</p> Signup and view all the answers

    Which of the following drugs is an oral agonist of thrombopoietin?

    <p>Eltrombopag (B)</p> Signup and view all the answers

    Which statement regarding hydroxycarbamide is true?

    <p>It functions as a cytotoxic drug. (D)</p> Signup and view all the answers

    What is the primary role of tetrahydrofolate (FH4) in the body?

    <p>DNA synthesis and amino acid metabolism (B)</p> Signup and view all the answers

    Which condition is a common reason for the treatment of megaloblastic anemia with folic acid?

    <p>Poor dietary intake (A)</p> Signup and view all the answers

    Why is vitamin B12 typically administered via injection?

    <p>It is poorly absorbed orally due to intrinsic factor requirements (B)</p> Signup and view all the answers

    In what scenario is prophylactic administration of folic acid particularly important?

    <p>For pregnant women and those planning conception (A)</p> Signup and view all the answers

    Which of the following statements regarding erythropoietin is NOT true?

    <p>It is always administered orally. (D)</p> Signup and view all the answers

    What is a common adverse effect associated with erythropoietin therapy?

    <p>Influenza-like symptoms (A)</p> Signup and view all the answers

    Which component is critical for the absorption of vitamin B12 in the body?

    <p>Intrinsic factor (B)</p> Signup and view all the answers

    What distinguishes Darbepoetin from Epoetin in clinical use?

    <p>Longer half-life allowing for less frequent administration (D)</p> Signup and view all the answers

    Flashcards

    What is Anemia?

    A condition characterized by a decrease in red blood cells (RBCs), hemoglobin concentration, or hematocrit, leading to reduced oxygen transport to tissues.

    How is Anemia Diagnosed?

    Anemia diagnosed when hemoglobin levels fall below 13 g/dL in men and 12 g/dL in women, though these values can vary based on the population and laboratory reference ranges.

    What is Hypochromic, Microcytic Anemia?

    This type of anemia is characterized by abnormally small red blood cells (microcytic) with reduced hemoglobin content (hypochromic).

    What is Macrocytic Anemia?

    This type of anemia involves abnormally large red blood cells (macrocytic).

    Signup and view all the flashcards

    What is Normochromic Normocytic Anemia?

    Normochromic normocytic anemia refers to a decreased number of red blood cells that are normal in size and hemoglobin content.

    Signup and view all the flashcards

    What is a Hematinic Agent?

    A substance or drug that promotes the formation of blood, particularly by stimulating the production of red blood cells (erythropoiesis) or hemoglobin.

    Signup and view all the flashcards

    What are some types of Hematinic Agents?

    Iron, Folic acid, and Vitamin B12 (cobalamin) are commonly used hematinic agents in the treatment of anemia.

    Signup and view all the flashcards

    How is Iron Metabolized?

    The metabolic pathway of iron involves absorption, transport, storage, and utilization within the body.

    Signup and view all the flashcards

    Oral Iron Supplementation

    Iron deficiency anemia is treated with orally administered iron supplements, like ferrous sulfate, ferrous succinate, ferrous gluconate, and ferrous fumarate. Absorption is improved by taking these supplements with vitamin C.

    Signup and view all the flashcards

    Parenteral Iron Administration

    Parenteral iron administration is used when oral iron absorption is impaired, oral preparations are poorly tolerated, or in cases of chronic renal failure or chemotherapy-induced anemia.

    Signup and view all the flashcards

    Iron-Dextran and Iron-Sucrose

    Iron-dextran and iron-sucrose are examples of parenteral iron preparations typically administered through intramuscular or intravenous routes. They are used in cases of malabsorption, intolerance to oral iron, chronic kidney failure, and chemotherapy-induced anemia.

    Signup and view all the flashcards

    Acute Iron Toxicity

    Acute iron toxicity presents with severe symptoms such as necrotizing gastritis, vomiting, hemorrhage, diarrhea, and circulatory collapse. This is a medical emergency due to the potential for life-threatening complications.

    Signup and view all the flashcards

    Desferrioxamine for Iron Overload

    Desferrioxamine is a medication used to treat acute iron overload by binding iron in the gastrointestinal tract, preventing its absorption into the bloodstream. This is crucial for managing iron poisoning.

    Signup and view all the flashcards

    Chronic Iron Toxicity

    Chronic iron toxicity affects patients with conditions like thalassaemia and hemochromatosis, leading to abnormal iron accumulation in the body.

    Signup and view all the flashcards

    Chronic Iron Overload Treatment

    Desferrioxamine and deferiprone are medications used to treat chronic iron overload in patients with conditions like thalassemia and hemochromatosis. They help remove excess iron from the body.

    Signup and view all the flashcards

    Folic Acid

    Folic acid is an essential nutrient obtained from liver and green vegetables. Its daily requirement is 0.2 mg for healthy adults, but this increases during pregnancy.

    Signup and view all the flashcards

    What is the role of FH4 in the body?

    Folic acid is converted into tetrahydrofolate (FH4), which is essential for DNA synthesis and amino acid metabolism.

    Signup and view all the flashcards

    Where is folic acid absorbed?

    Folic acid is absorbed in the ileum, the last section of the small intestine.

    Signup and view all the flashcards

    How does folic acid help with methotrexate toxicity?

    Folic acid can prevent toxicity from the drug methotrexate.

    Signup and view all the flashcards

    Who needs folic acid supplementation?

    Folic acid deficiency can be prevented in pregnant women, premature infants, and patients with severe chronic hemolytic anemias.

    Signup and view all the flashcards

    What are the sources and absorption of vitamin B12?

    Vitamin B12 (hydroxocobalamin) is primarily found in meat, eggs, and dairy products. It's absorbed in the terminal ileum with the help of intrinsic factor.

    Signup and view all the flashcards

    What are the main functions of vitamin B12?

    Vitamin B12 plays a crucial role in DNA synthesis, converting methyl-FH4 to FH4, and forming succinyl-CoA from methylmalonyl-CoA.

    Signup and view all the flashcards

    How is Vitamin B12 administered and why is it important in pernicious anemia?

    Vitamin B12 injections are commonly used in cases of pernicious anemia, a condition where the body cannot absorb B12 from food. Patients may receive maintenance injections every 3 months.

    Signup and view all the flashcards

    What does erythropoietin do?

    Erythropoietin stimulates the production of red blood cells (erythrocytes) in the bone marrow.

    Signup and view all the flashcards

    Erythropoietin (EPO)

    A hormone produced by the kidneys that stimulates the production of red blood cells in the bone marrow.

    Signup and view all the flashcards

    Hematopoietic Growth Factors

    A group of proteins that stimulate the growth and development of blood cells.

    Signup and view all the flashcards

    Granulocyte Colony-Stimulating Factor (G-CSF)

    A type of hematopoietic growth factor that specifically promotes the production of white blood cells called neutrophils.

    Signup and view all the flashcards

    Thrombopoietin

    A type of hematopoietic growth factor that stimulates the production of platelets.

    Signup and view all the flashcards

    Hemolytic Anemia

    A group of diseases characterized by excessive destruction of red blood cells. This can lead to anemia.

    Signup and view all the flashcards

    Sickle Cell Anemia

    A hereditary blood disorder caused by a mutation in the beta-globin gene, resulting in abnormal hemoglobin (HbS) and red blood cell shape.

    Signup and view all the flashcards

    Thalassemia

    A genetic disorder that affects hemoglobin production, leading to a deficiency of red blood cells.

    Signup and view all the flashcards

    Paroxysmal Nocturnal Hemoglobinuria (PNH)

    A rare blood disorder characterized by red blood cell destruction and blood clots, often caused by a genetic defect.

    Signup and view all the flashcards

    Study Notes

    Anemia Treatment

    • Anemia is a clinical condition defined by a decrease in red blood cell (RBC) count, hemoglobin concentration, or hematocrit, which hinders oxygen transport to tissues.
    • Diagnosed when hemoglobin levels fall below 13 g/dL in men and 12 g/dL in women; these values vary based on population and lab standards.
    • Anemia symptoms are often nonspecific and stem from decreased oxygen delivery. Common symptoms include fatigue, weakness, dizziness, pallor, shortness of breath, tachycardia, palpitations, angina, headache, and difficulty concentrating. Neurological issues like paresthesias and ataxia can occur, particularly in B12 deficiency.

    Pathophysiology of Anemia

    • Anemia's causes are multifaceted, with some genetic factors playing a role, and excessive bleeding, or menstrual bleeding, among other causes.
    • Types include hypochromic, microcytic; macrocytic; and normochromic, normocytic anemia.

    Treatment of Anemia

    • Treatment strategy hinges on the underlying cause and severity of the condition.
    • Haematinic agents are substances promoting blood formation, typically by boosting red blood cell or hemoglobin production, iron, folic acid, and Vitamin B12 are examples.
    • Haematopoietic growth factors stimulate blood cell production, like erythropoietin to address anemia caused by deficiency, particularly in chronic kidney disease, AIDS, or cancer.
    • Treatment of hemolytic anemia targets the increased destruction of red blood cells. Strategies vary depending on the cause of hemolysis (e.g., genetic mutations, infections).

    Haematinic agents (Iron)

    • Iron is usually administered orally, sometimes with Vitamin C to improve absorption.
    • Oral forms: ferrous sulfate, ferrous succinate, ferrous gluconate, ferrous fumarate
    • Parenteral forms: Iron-dextran, Iron-sucrose
    • Adverse reactions (ADR) to oral iron include nausea, abdominal cramps, and diarrhea. Parenteral iron can cause anaphylactic reactions and infections. Acute iron toxicity can lead to severe gastritis, hemorrhage, and circulatory collapse.
    • Iron metabolism: Iron absorption from the diet occurs in the gastrointestinal tract (GIT). Iron is stored as ferritin or haemosiderin in the liver.

    Haematinic agents (Folic acid)

    • Important for DNA synthesis, amino acid metabolism, and nucleotide production.
    • Sources include liver and green vegetables.
    • Daily requirement is approximately 0.2 mg in healthy non-pregnant adults, increasing during pregnancy.
    • Administered orally and absorbed in the ileum.
    • Clinical uses include malabsorption syndromes, treatment/prevention of methotrexate toxicity, prophylaxis for pregnant women, before conception, and in premature infants.

    Haematinic agents (Vitamin B12)

    • The therapeutic preparation is called Hydroxocobalamin.
    • Sources include meat, eggs, and dairy products.
    • Daily requirement is 2-3 µg.
    • Absorption depends on intrinsic factors secreted by gastric parietal cells.
    • Stored in the liver.
    • Functions include DNA synthesis, conversion of methyl-FH4 to FH4, and isomerization of methylmalonyl-CoA to succinyl-CoA.
    • Administered via injection, typically lifelong in patients with pernicious anemia, and weekly/biweekly in some cases.
    • Often given prophylactically, after abdominal surgery that impacts its production and/or absorption.

    Haemopoietic growth factors

    • Erythropoietin is a glycoprotein stimulating erythroid progenitor cell proliferation for red blood cell generation. Uses include treating anemia due to deficiency (e.g., chronic kidney disease, AIDS).
    • Recombinant human erythropoietins (like epoetin and darbepoetin) are used. Darbepoetin has a longer half-life and can be administered less frequently.
    • Adverse reactions include influenza-like symptoms and hypertension.
    • Clinical uses for erythropoietin include anemia of chronic renal failure, anemia during cancer chemotherapy, and prevention of anemia in premature infants. Additionally, it can be used to increase the yield of autologous blood before donation and treating anemia in HIV patients exacerbated by zidovudin use.

    Treatment of Haemolytic Anemia

    • Anemia linked with increased red blood cell destruction.
    • Genetic causes include sickle cell disease (mutations in the HBB gene affecting hemoglobin S production) and thalassemia.
    • Non-genetic causes encompass autoimmune disorders, infections, and adverse drug reactions.
    • Treatment is typically symptomatic. Analgesics for painful crises, supportive care like fluid balance and oxygen therapy, and blood transfusions are commonly employed. Antibiotics may be needed depending on the cause.
    • Drugs such as hydroxycarbamide (a cytotoxic drug) are used to lower red blood cell and platelet counts in conditions like polycythemia, chronic myeloid leukemia, or sickle cell disease.
    • Eculizumab, a monoclonal antibody, treats paroxysmal nocturnal hemoglobinuria (PNH).

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Lesson 24 - Treatment of Anemia PDF

    Description

    This quiz assesses your knowledge of iron administration, particularly in patients with chronic renal failure. It covers topics such as iron toxicity, erythropoietin production, and dietary sources of folate. Test your understanding of these critical components of patient care and nutrition!

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser