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Diagnosis and Management of Iron Deficiency Anemia

Iron deficiency is the most common nutritional deficiency in the world. In the United States iron deficiency most commonly occurs in toddlers (7%) and adult/adolescent females (9-16%).1 Iron Deficiency Anemia (IDA) is identified by abnormal iron laboratory values in addition to low hemoglobin levels. Patients with IDA may be asymptomatic, or may have signs and symptoms such as headache, fatigue, tachycardia, exertional tachypnea and pica (a craving for substances that are generally non nutritive such as ice, chalk and soil).

One of the most common causes of iron deficiency in adult
Americans is acute blood loss, such as that which occurs in gastrointestinal (GI) bleeding, trauma, surgery and postpartum bleeding. Other causes include malnutrition, decreased iron absorption, celiac disease, use of erythropoietin stimulating agents (ESAs), chronic illness, gastric bypass surgery, and congenital iron deficiency. IDA is associated with an increased susceptibility to infections, decreased work productivity, and slower cognitive and motor development in children.2-4 In addition, there is an association between low hemoglobin and preterm birth as well as lower birth weight.5

This article will review the pathophysiology of IDA and how to assess laboratory values and treatment options. Pharmacists must be aware of the proper dosing of oral and intravenous (IV) iron supplementation, how to counsel patients on proper use of iron supplements and how to manage drug-drug and drug-food interactions.

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Diagnosis and Management of Iron Deficiency Anemia