Tratamento da anemia ferropriva com ferro por via oral

Abstract

IntroduçãoO tratamento da anemia ferropriva foi introduzido por Blaud, em 1832, com um composto cujo principal constituinte era o carbonato férrico. A "pílula de Blaud" permaneceu como pilar do tratamento da deficiência de ferro por mais de cem anos, até o aparecimento de novos compostos com ferro. 1O tratamento da anemia ferropriva consiste da orientação nutricional (tema específico abordado em outro artigo deste fascículo), administração por via oral ou parenteral de compostos com ferro e, eventualmente, transfusão de hemácias.A identificação e correção, quando possível, da causa -ou causas -que levaram à anemia, associadas à reposição do ferro, na dose correta e por tempo adequado, resultam, na maioria das vezes, na sua correção e, consequentemente, confirmam o diagnóstico.Tratar a anemia ferropriva sem identificar sua causa pode significar a perda da oportunidade de se diagnosticar

Intravenous iron sucrose for treatment of anemia in gynecology patients awaiting surgery

“…Due to noncompliance on the part of patients its efficacy is limited in many patients because of the side effects related to the drug, particularly gastrointestinal disturbances occurring in 50% of patients and the long course needed to treat anemia and replenish iron stores. 15,16 Non-compliance to oral iron is common and, even in compliant patients, because of poor absorption iron therapy still is required in the patients with AUB or with chronic blood loss. 15,16 While intravenous (IV) iron by passes these problems, fear remains about its harmful effects and the potential for long-term hazards from multiple doses of iron administration.…”

“…15,16 Non-compliance to oral iron is common and, even in compliant patients, because of poor absorption iron therapy still is required in the patients with AUB or with chronic blood loss. 15,16 While intravenous (IV) iron by passes these problems, fear remains about its harmful effects and the potential for long-term hazards from multiple doses of iron administration. 17,18 Parenteral iron preparations which were available in the olden days were associated with dangerous complications like anaphylactic reactions and death, due to which they have gone in disrepute.…”

Efficacy and safety of high dose accelerated intravenous iron sucrose in patients of iron deficiency anemia

“…As reported in some studies its efficacy may, however, be limited in many patients because of the side effects related to the drug, particularly gastrointestinal toxicity occurring in up to 35% to 59% of patients and the long course needed to treat anemia and replenish iron stores. 3,4 Non-adherence to a prescribed course of oral iron is common and, even in adherent patients, poor intestinal absorption fails to compensate for iron need in the presence of ongoing blood losses. 3,4 Intravenous iron sucrose can be given to patients who are unable to tolerate oral iron; whose needs are relatively acute; or who need iron on an ongoing basis, usually due to persistent gastrointestinal blood loss.…”

“…3,4 Non-adherence to a prescribed course of oral iron is common and, even in adherent patients, poor intestinal absorption fails to compensate for iron need in the presence of ongoing blood losses. 3,4 Intravenous iron sucrose can be given to patients who are unable to tolerate oral iron; whose needs are relatively acute; or who need iron on an ongoing basis, usually due to persistent gastrointestinal blood loss. While intravenous (IV) iron has the capability of bypassing all these issues, concerns remain about the acute safety profiles of the available products and the potential for long-term harm from repeated iron administration.…”

“…While intravenous (IV) iron has the capability of bypassing all these issues, concerns remain about the acute safety profiles of the available products and the potential for long-term harm from repeated iron administration. 4,5 The common intravenous regimen utilized for replacement of iron in rural areas consists of multiple injections of 200mg of iron sucrose given over an extended period of two weeks.…”