complete treatment guidelines about the iron deficiency anaemia.it gives information about all forms of treatment.information given is more than enough for a medical student

2. APPROACH
Depends on
• Severity and Cause
• Ability of the patient to tolerate
• Absorption capacity

3. TREATMENT OF CAUSE
Underlying cause for iron deficiency should
be treated
Such as upper GI bleed , peptic ulcer ,
menorrahagia

4. Rx
RED CELL TRANSFUSION
ORAL IRON THERAPY
PARENTERAL IRON THERAPY

6. INDICATIONS

7. • Mainly related to severity of anaemia
than to iron deficiency
• Not only corrects anaemia acutely but
also acts as a source of iron for
reutilization
• Stabilizes the patient

8. Mainly done for the patients with Hb < 8 gm/dl
 Iron content of packed red cells is around 1 mg of
haeme iron per ml
Expected Hb level after transfusion of 1 unit is 1
gm/dl
Iron stores replenishes in 2-3 weeks

10. • Asymptomatic patients with
established IDA
• Simple salts to complex iron
compounds
• Ascorbic acid
combination to enhance
absorption

11. Oral iron supplements
• Ferrous sulphate (52%)
• Ferrous succinate (35%)
• Ferrous fumarate (33%)
• Ferrous gluconate (12%)

13. IRON TOLERANCE TEST
2 Iron tabs given
Serum Iron at 2 hrs
At least 100 mcg/dl

14. Do’s
Empty stomach

15. Dont’s

16. Monitoring
• Increase in reticulocyte count
after 4-7 days
• Increase in Hb level after 3-4
weeks

17. Monitoring
• Reconsider the diagnosis if no response
• Reveal the cause for poor response
(prolonged bleeding ,poor patient
compliance)
• Don’t continue the treatment beyond 3-4
weeks if there is no favourable response

18. Nausea,vomiting
Heart burn
Abdominal
discomfort
Constipation

21. INDICATIONS
Iron malabsorption
Severe oral iron intolerance
Haemodialysis patient
Patients on erythropoietin Therapy
Non compliance patients

22. Iron Dextran
Ferumoxytol (510 mg / inj )
Sodium Ferric Gluconate (125mg /inj )
Iron Sucrose (200mg/inj )
Ferric Carboxymaltose (750mg/inj )
Parenteral preparations

23. GOAL
1.To correct Hb deficit and provide
atleast 500mg of iron stores
2.Repeated small doses in a
protracted period

24. Formula to Calculate Iron need
• Body weight(Kg) x 2.3 (15 – Patient’s
Hb,gm/dl) + 500 or 1000mg(Store)

25. Drug of Choice
• IM (Z-track technique) Iron Dextran 2ml
daily on Alternate days
• IV (Test dose-0.5ml) of Iron dextran over
5-10 minutes,2ml can be injected/day
taking 10 mins for inj.

26. Newer Preparations
 Ferrous sucrose-100mg IV in
5mins(once daily/weekly)
Ferric carboxymaltose(latest
formulation) 100mg IV or 1000mg
diluted with saline in 15 mins

27. IRON DEFICIENCY ANAEMIA
IN PREGNANCY
Depends on degree of anaemia &period
of gestation
Blood transfusion: severe anaemia,
near term or if she is in labour
Oral treatment : Ferrous salts
given 200 mg TDS

28. Intramuscular therapy : Iron dextran
complex ,Iron- sorbitol -citric acid complex
Oral iron is stopped 24 hrs priorly
Intravenous therapy: Iron dextron diluted in
500ml of 5% glucose as slow iv as needed

29. Closely observe during IV infusion

31. PREVENTION

37. Initiative by TN govt

39.  Treat the underlying cause
 Treat the anaemia
 Replenish the Iron stores