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Unformatted text preview: to the function of Iron Hemoglobin Myoglobin Iron-containing enzymes 67 Iron in the Body Iron Fate in the body – Uptake and distribution Uptake into mucosal cells in small intestine Undergoes storage within mucosal cells Undergoes binding to transferrin – Utilization and storage Taken up by cells of the bone marrow Taken up by the liver and other tissues Taken up by muscle – Recycling – undergoes continuous recycling Recycling undergoes – Elimination – 1 mg of iron excreted each day Elimination mg – Regulated through control of intestinal Regulated absorption absorption 68 Iron Iron Daily requirements – Determined by rate of erythrocyte production – Increased requirement during pregnancy the infant is taking the mother’s iron Dietary sources – Available in foods of plant and animal origins 69 Iron Deficiency: Causes, Consequences, and Diagnosis Consequences, Results when there is an imbalance in iron Results uptake and iron demand uptake Causes Causes – Pregnancy (blood volume expansion) – Infancy and early childhood – Chronic blood loss- period Chronic Consequences – Microcytic, hypochromic anemia 70 Oral Iron Preparations: Iron Salts Oral Ferrous sulfate – Indications—drug of choice – Prophylactic therapy Adverse effects – GI disturbances – Staining of teeth – Toxicity Drug interactions – Antacids (inhibit it) – (inhibit it) – Ascorbic acid (vitamin C will inhibit it) 71 Parenteral Iron Preparations Parenteral Iron Dextran Iron Iron dextran (INFeD, DexFerrum) Used for patients who have experienced Used intolerable or ineffective oral dosing intolerable Adverse effects – Anaphylactic reactions – Hypotension – Persistent pain with IM injection 72 Vitamin B12 (Cobalamin) Vitamin Essential for synthesis of DNA Absorption requires intrinsic factor (GI Absorption system) system) Elimination takes place very slowly Daily requirement Dietary sources – A llot is in cereal ot – Limited to microorganisms – Animal products (liver, dairy products) – Fortified foods 73 Vitamin B12 Deficiencies: Causes, Vitamin Consequences, and Diagnosis Consequences, Causes – Usually result of impaired absorption – Regional enteritis – Celiac disease – Absence of intrinsic factor 74 Vitamin B12 Preparations: Vitamin Cyanocobalamin Cyanocobalamin Administration Oral, parenteral, intranasal – Adverse effects Adverse Hypokalemia – Long-term treatment With lack of intrinsic factor, vitamin B12 therapy lifelong lifelong 75 Folic Acid Anemia Folic Folic acid – Essential factor for DNA synthesis DNA replication Cell division cannot proceed – Absorbed in the early segment of the small Absorbed intestine intestine – Significant amounts excreted daily – Dietary sources – all foods Dietary 76 Folic Acid Treatment Folic Pteroylglutamic acid (Folic Acid) Choice of treatment Prophylactic use of folic acid Treatment of severe deficiency 77 Hematopoietic Growth Factors 78 Hematopoietic Growth Factors Hematopoietic Process by which blood cells and platelets Process are produced are Types – Hematopoietic growth factor Erythropoietic (RBCs) Leukopoietic (WBCs) – Thrombopoietic growth factor Oprelvekin (platelets) (Interleukin-11) 79 Erythropoietic Growth Factors Erythropoietic Also known as ESAs (erythropoiesis Also stimulating agents) stimulating Adverse effects – Increased risk of DVT when used prior to Increased elective surgery elective – For patients with...
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