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What is Indication for intramuscular iron therapy? and explain in detail?
Ans. d (Oral iron intolerance). (Ref. KDT, Pharmacology, 6th/pg.584)IRON THERAPY# Some iron preparations come with other compounds designed to enhance iron absorption, such as ascorbic acid,# Typically, for iron replacement therapy, up to 300 mg of elemental iron per day is given, usually as three or four iron tablets (each containing 50-65 mg elemental iron) given over the course of the day.# Ideally, oral iron preparations should be taken on an empty stomach, since foods may inhibit iron absorption.# A dose of 200-300 mg of elemental iron per day should result in the absorption of iron up to 50 mg/d.# The goal of therapy in individuals with iron-deficiency anemia is not only to repair the anemia, but also to provide stores of at least 0.5-1.0 g of iron.# Sustained treatment for a period of 6-12 months after correction of the anemia will be necessary to achieve this.# Of the complications of oral iron therapy, gastrointestinal distress is the most prominent and is seen in 15-20% of patients.# Typically, the reticulocyte count should begin to increase within 4-7 days after initiation of therapy and peak at 1 1/2 weeks.# The amount of iron needed by an individual patient is calculated by the following formula:Iron requirement (mg) =4.4 X bidt wt (kg) X Hb defucut (g/dL)Indications of parenteral Iron therapy# Oral iron intolerance# Failure to absorb oral iron# Non-compliance to oral therapy# In presence of severe anemia with bleeding.Oral Iron preparationsIron contentFerrous sulfate Hydrated salt20%Dried salt32-35%Ferrous gluconate12%Ferrous fumarate, succinate33%Colloidal ferric hydroxide50%Iron-calcium complex5% Iron therapy:Dosage ------200mg elemental iron per dayRise of Hb --------0.5-lgm% per week1st sign of response --------| Apetite, | fatigue within 12-24 hrs Reticulocytosis 3-4th DayIndication of Blood transfusion------Hb < 7gm% or CCFDuration of iron tablets ------At least 100 days after correction of Hb