12 Questions
What is the recommended dose of elemental iron for iron deficiency anemia?
20-30mg/kg/day
Which iron supplement provides 30% of elemental iron and is the most tried and tested preparation?
Ferrous sulfate
What is the relative bioavailability of ferrous salts compared to ferric salts?
20%, 12%, and 33%
Which newer generation iron preparation claims to have less gastrointestinal side effects and can be taken as a once-a-day dose?
Iron glycine sulfate
What is a common feature of ferrous iron polymaltose complex compared to modified release iron tablets?
Better tolerability
Why is it important to fortify foods with iron and encourage natural iron intake in the diet?
To address iron deficiency anemia in a holistic way
What is the standard recommended dose of oral iron therapy?
180 mg three times a day
Which iron salt is well tolerated but expensive and requires a prescription?
Ferrous fumarate
What is a common method to manage gastrointestinal side effects of oral iron salts?
Reducing the dose or changing the salt preparation
Which form of oral iron supplementation has been suggested to cause fewer gastrointestinal side effects?
Slow-release iron preparations
In which condition is oral iron supplementation generally contraindicated?
Chronic hemolytic anemias
According to an older study, which dosage of ferrous gluconate was found to be more effective and less toxic than ferrous sulfate?
300 mg daily
Study Notes
Ferrous Salts and Iron Deficiency Anemia
- Ferrous salts are the most commonly prescribed supplements for iron deficiency anemia, with a dose of 20-30mg/kg/day in divided doses.
- Ferrous sulfate is the most tried and tested preparation, providing 30% of elemental iron.
Types of Oral Iron Supplements
- There are two main types of oral iron supplements: ferrous and ferric salts.
- Ferrous salts have a relative bioavailability of 20%, 12%, and 33%.
- Ferrous sulphate is the most cost-effective but has more gastrointestinal side effects and is poorly tolerated.
- Ferrous gluconate contains 12% elemental iron, has less gastrointestinal effects, and is dosed once to three times daily.
- Ferrous fumarate contains 33% elemental iron, is well tolerated, but is expensive and requires a prescription.
Dosage and Administration of Oral Iron Supplements
- The standard recommended dose is 200 mg three times a day, providing 180 mg of elemental iron per day.
- Lower doses of iron are as effective as higher doses if they can be absorbed.
- Reducing the frequency of dosing is important for improving compliance.
Side Effects and Precautions of Oral Iron Supplementation
- Oral iron supplementation is generally contraindicated in certain conditions, such as chronic hemolytic anemias and anemia of chronic disease.
- Iron supplementation can cause systemic allergic reactions, such as rashes, hives, arthralgia, and myalgia.
- Gastrointestinal side effects, such as constipation, diarrhea, nausea, vomiting, epigastric discomfort, and black tarry stools, are common with oral iron salts.
- Patients experiencing gastrointestinal side effects may benefit from adjunctive therapy with vitamin C and/or a short course of an antiemetic.
Test your knowledge on the most commonly prescribed iron supplements for iron deficiency anemia, including ferrous sulfate, ferrous gluconate, ferrous fumarate, and ferrous iron polymaltose complex. Learn about recommended dosages and elemental iron content for each supplement.
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