Page 195 - pharma 1 theoretical updated MNU_Neat

Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)

2) Parenteral iron therapy
 Indicated for IDA patients who:

1) Cannot tolerate gastrointestinal side effects of oral iron E.g. older individuals,
pregnant individuals and individuals with existing gastrointestinal disorders.

2) Fail to respond to oral iron because of malabsorption syndromes.
3) Ongoing/severe blood loss that exceeds the capacity of oral iron to meet needs (e.g.,
heavy uterine bleeding, varices)

4) Gastric surgery (bypass, resection) that ↓ gastric acid → ↓ intestinal absorption of oral
iron.
5) Coexisting inflammatory state that interferes with iron homeostasis.

Iron-dextran (ID)
• For IM/IV injection

• The high molecular weight ID (HMW-ID) causes more life threatening anaphylactic-
like reactions > LMW-ID ➔ Because of the risk of anaphylaxis, a test dose of iron dextran
(0.5 ml= 25 mg) must be administered to patients before their first dose of ID → monitor

BP and HR for 1 h.

• LMW-ID can be administered:

o in 100-mg doses daily until the total dose is achieved.
o by total dose infusion (TDI) → the total calculated dose can be administered safely in
saline in 1 day → similar outcome & ↓ cost.

Calculation of dose in Iron Therapy

LBW (Lean body weight) = body weight – body fat

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