Pharmacotherapy of _____Anemia_____



Pharmacotherapy of _____Anemia, Iron Deficiency_____

Nicholas Tsourounis, PharmD Candidate 2007

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|Epidemiology |Approximately 3.4 million Americans have some form of anemia |

| |175,000 nursing home residents have anemia |

| |7% of children 1 to 2 years of age have anemia |

| |12% of females ages 12 to 49 have anemia |

| |Iron deficiency is the most common cause of anemia, accounting for 1/4th of all anemia cases |

| |4,500 deaths per year because of all types of anemia combined |

| |Effects on Productivity |

| |loss of productivity of workers with anemia due to weakness and fatigue |

| |Ethnic Differences |

| |people of Mexican-American descent have 3x the rate of iron deficiency anemia as compared to Caucasians, according to results from the |

| |National Health and Nutrition Examination Survey (NHANES III) |

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|Disease State |Anemia refers to a group of diseases that are characterized by a decrease in hemoglobin or a reduction in the oxygen carrying capacity of |

|Definition |the blood. |

|Patho-physiology | |

| |Classification of anemia is based on red blood cell (RBC) morphology, its cause, or its pathophysiology |

| |RBC morphology is based on cell size (macrocytic, normocytic, or microcytic) and iron content (hypochromic or normochromic) |

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| |Iron deficiency anemia is usually caused by inadequate iron intake through diet, inadequate absorption through the gastrointestinal tract, |

| |increased demand by the body for iron (such as during pregnancy), blood loss, iron loss due to dialysis in chronic renal failure, and other|

| |chronic diseases where iron release from reticuloendothelial cells may be blocked |

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|Clinical Presentation | |

| |Clinical presentation of anemia patients depends on the etiology and speed of onset |

| |When onset is more rapid, anemia usually presents as cardiorespiratory symptoms such as tachycardia, light headedness, and shortness of |

| |breath |

| |When onset is due to a chronic condition, anemia cases usually present as fatigue, headache, vertigo, fainting, decreased cold tolerance, |

| |pallor, and loss of skin tone |

| |Iron deficiency is characterized by spooning of the nails, angular stomatitis, glossitis, smooth tongue, brittle nails, cracks in the |

| |corners of the mouth (cheilosis), dysphagia due to esophageal webs, and strange dietary cravings (pica). |

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|Risk Factors |Being of Mexican-American descent |

| |Prolonged bottle-feeding as an infant |

| |Heavy menstrual periods |

| |Pregnancy |

| |A diet low in iron content |

| |Known or unknown source of blood loss |

| |Vegetarianism |

| |Female |

| |Infants/children undergoing rapid growth |

| |Long term NSAID therapy |

| |Colon cancer |

| |Peptic ulcer disease |

|Diagnosis |Diagnosis of iron deficiency anemia is based on a Complete Blood Count that includes RBC indices and a reticulocyte index, as well as a |

| |peripheral blood smear and Fecal Occult Blood Test. |

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| |According to the World Health Organization (WHO) criteria, anemia is diagnosed in males when Hb is ................
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