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Query: UMLS:C0240066 (iron deficiency)
 7,156 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nursing management of anemic dialysis patients requires a thorough understanding of the conditions that can potentially affect erythropoiesis. Erythropoietin deficiency has been documented as the primary cause of the anemia of uremia, and Epoetin alfa has proven to be an effective therapy for correcting this condition. However, other etiologies, independent of the uremic process, can also contribute to anemia in these patients and lead to a diminished response to Epoetin alfa. Iron deficiency and blood loss, for example, are well-documented etiologies that can hinder erythropoiesis and diminish the response to Epoetin alfa (Van Wyck, 1989). Another etiology still under investigation is the potential effect of infection or inflammation on the response to Epoetin alfa. This article examines the anemia of infection and inflammation and the potential effect on response to Epoetin alfa.
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PMID:Case management of the anemic patient. Epoetin alfa: focus on inflammation and infection. 225 31

The characteristics and uses of epoetin alfa (recombinant human erythropoietin) are described, and the issues associated with its use are discussed. The use of epoetin alfa was recently approved by FDA for the treatment of anemia associated with end-stage renal disease. Epoetin alfa acts on burst-forming and colony-stimulating units in the blood to raise hemoglobin and hematocrit levels, thus correcting the patient's anemia. It has a relatively short half-life and may be given either i.v. or s.c. Doses vary and must be adjusted according to the individual patient response. Clinical trials have involved doses ranging from 15 to 500 units/kg three times per week. Treatment causes a dose-related rise in the hematocrit, with subsequent improvement in the quality of life of dialysis patients. Adverse effects include hypertension, iron deficiency, and thrombocytosis. Additional research indicates that epoetin alfa may be effective in the correction of other uncomplicated anemias, such as those related to antineoplastic therapy. Issues facing hospital pharmacists and other health-care professionals include cost (the estimated cost of therapy is $4000 to $8000 per patient per year), appropriate use and potential misuse, use and reimbursement for indications not included in FDA-approved labeling, and restriction to particular prescribers. Because epoetin alfa does not produce therapeutic effects for at least 7 to 14 days, it is an ideal agent for formulary restriction. Epoetin alfa, like other products of biotechnology, will have substantial impact, both therapeutic and economic, on the practice of pharmacy. Hospital pharmacists need to be aware of these new therapies so that they may act quickly and decisively when issues associated with their use arise.
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PMID:Recombinant human erythropoietin. 269 Jun 6

Red blood cell formation relies on the contributions of a variety of substances, including iron, vitamins, and protein. Therapeutic intervention with Epoetin alfa changes the requirements for these erythropoietic ingredients, frequently necessitating modifications in nutritional prescriptions. Nursing knowledge and management of the nutritional components that affect erythropoiesis can help ensure optimal patient response to therapy. Case study illustrations of iron deficiency and potassium excess are used to demonstrate potential nursing interventions.
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PMID:Epoetin alfa--focus on nutritional therapy. Case study of the anemic patient. 890 Jun 89

Approximately 50% of cancer patients develop anemia. In the past, the only available treatment option for these patients was transfusion. Since the late 1980s, recombinant human erythropoietin (rHuEPO, epoetin alfa [Epogen, Procrit]) has provided a treatment alternative. Controlled clinical trials have shown that rHuEPO increases hemoglobin and hematocrit levels and reduces the need for transfusions in patients with cancer-related anemia. These controlled trials have suggested (as larger, uncontrolled studies) that the improvements in hemoglobin are associated with increases in energy level, functional status, and overall quality of life. However, only about 50% of patients respond adequately to usual doses of rHuEPO. In the chronic renal failure population, functional iron deficiency is the most common cause of inadequate response to rHuEPO. It has been hypothesized that functional iron deficiency may also occur in cancer patients receiving rHuEPO and may account for the lack of response in up to half of those patients. Studies in renal failure patients have shown that administration of intravenous iron can correct functional iron deficiency more effectively than oral iron and may improve response to rHuEPO. Intravenous iron also reduces the total amount of rHuEPO needed to normalize hematocrit and hemoglobin levels, thereby reducing treatment costs. Ongoing clinical trials are evaluating whether IV iron can also improve rHuEPO responsiveness in patients with cancer-related anemia.
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PMID:Role of iron in optimizing responses of anemic cancer patients to erythropoietin. 1023

Iron deficiency is a frequent complication in chronically ill patients and in pregnant women. Iron status can now be characterised precisely and relatively easily by determining serum ferritin, transferritin saturation and if necessary hypochromic erythrocytes and the haemoglobin content of erythrocytes (CHr). Oral iron replacement is usually restricted by limited absorption and low tolerability. Intravenous iron therapy is possible in such cases and can be combined with rHuEPO (e.g. EPREX/Epoetin alfa) in severe cases. Iron saccharate Switzerland and this permits high dose iron replacement without any danger of anaphylaxis or acute iron toxicity.
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PMID:[The iron letter--an update on the treatment of iron deficiency anemia]. 1655 Jul 9