anemia- Commmunity heealtth nuuursingHN.pptx

anemia- CHN.pptx

1. Outline Definition Quick facts Symptoms Classification Causes High Risk Population Anemia workup Non-pharmacologic Treatment Pharmacologic Treatment Patient Education Conclusion References 2

2. Definition Anemia is defined by WHO as hemoglobin concentration: 3 Goodnough LT, Schrier SL. Evaluation and management of anemia in the elderly. Am J Hematol . 2014 Jan;89(1):88-96

3. Musallam KM, Tamim HM, Richards T, Spahn DR, Rosendaal FR, Habbal A, et al. Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet. 2011 Oct 15;378(9800):1396-1407. 41 Quick Facts 4

4. Symptoms 5 https://www.vectorstock.com/royalty-free-vector/anemia-symptoms-icons-vector-21452683

5. Classification 6 [chart]. ( n.d. ). Retrieved from http://narta.innovations2019.org/types-of-anemia-chart/all-types-of-anemia-with-full-anemia-definition-chart-and.html

6. Classification 7 [chart]. ( n.d. ). Retrieved from http://narta.innovations2019.org/types-of-anemia-chart/pin-on-college-life.html

7. Causes 8 ANEMIA. (2010, August 1). Retrieved from https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/539721

8. High Risk Population 9 James L Harper. (2019, September 7). ANEMIA. Retrieved from https://www.medscape.com/answers/202333-153172/what-populations-are-at-high-risk-for-iron-deficiency-anemia Blood donation >2 units/year in women >3 units/year in men

9. Anemia Workup Initiate when Crcl < 60 ml/min or hgb <11 g/dl 10 Anemia Testing Algorithm Lab Test Selection. ( n.d. ). Retrieved from https://arupconsult.com/algorithm/anemia-testing-algorithm

10. Importance of Treatment 11 Silverberg DS , et al. ( n.d. ). The importance of anemia and its correction in the management of severe congestive heart failure. - PubMed - NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12453537

11. Hb dangerously low (< 7 g/ dL ) When to Treat as an Inpatient? 12 Evan M. Braunstein . (2019, February). Treatment of Anemia. Retrieved from https://www.merckmanuals.com/professional/hematology-and-oncology/approach-to-the-patient-with-anemia/treatment-of-anemia

12. Drug Indication Benefits ESA EPO deficiency (Anemia of chronic disease) Hb increase, QOL improvement Oral Iron ID anemia (ferritin< 30 ng/ml Increase Hb and iron IV iron Anemia of chronic disease Increase response to ESA Lactoferrin Anemia of chronic disease Increase response to ESA, reduce inflammation Corticosteroids Hemolytic anemia Suppress the immune system Antithymocyte globulin & cyclosporine  Aplastic anemia Suppress the immune system Vitamins (B9 & B12) Macrocytic anemia Correct vitamin deficiency Treatment Options 13 Antonio Macciò . (2012, October 3). (PDF) Management of Anemia of Inflammation in the Elderly. Retrieved from https://www.researchgate.net/publication/232612155_Management_of_Anemia

13. Treatment Algorithm 14 Ingo Beyer. (2014, June 21). Table 1 Anemia in the elderly: overview. Retrieved from https://www.researchgate.net/figure/Anemia-in-the-elderly-overview_tbl1_43347737

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15. Non- pharmacologic Treatment 16 Franziska Spritzler . (2020, January 27). Retrieved from https://www.healthline.com/nutrition/11-healthy-iron-rich-foods

16. Pharmacologic Treatment 17

17. Oral Iron 18 UpToDate . ( n.d. ). Retrieved from https://www.uptodate.com/contents/ferrous-fumarate-drug-information?search=iron&source=panel_search_result&selectedTitle=1~140&usage_type=panel&display_rank=1

18. Oral Iron 19 Cont’d UpToDate . ( n.d. ). Retrieved from https://www.uptodate.com/contents/ferrous-fumarate-drug-information?search=iron&source=panel_search_result&selectedTitle=1~140&usage_type=panel&display_rank=1

19. Oral Iron 20 Ferrous fumarate 33% elemental iron Tablet only Ferrous gluconate 10 to 14% elemental iron Tablet only Ferrous sulfate Off Label: RLS 20 to 30% elemental iron Drops and oral solution, e lixir and solution, s yrup, tablet, ER tablet Polysaccharide-iron complex More expensive but lacks metallic taste 33% elemental iron Capsule, Elixir UpToDate . ( n.d. ). Retrieved from https://www.uptodate.com/contents/ferrous-fumarate-drug-information?search=iron&source=panel_search_result&selectedTitle=1~140&usage_type=panel&display_rank=1 Cont’d

20. Oral Iron 21 Cont’d UpToDate . ( n.d. ). Retrieved from https://www.uptodate.com/contents/ferrous-fumarate-drug-information?search=iron&source=panel_search_result&selectedTitle=1~140&usage_type=panel&display_rank=1

21. Food-Iron Interaction 22 Cont’d UpToDate . ( n.d. ). Retrieved from https://www.uptodate.com/contents/ferrous-fumarate-drug-information?search=iron&source=panel_search_result&selectedTitle=1~140&usage_type=panel&display_rank=1

22. Parenteral Iron 23

23. Parenteral Iron 24 Cont’d

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25. Non-Pharmacologic Treatment 26 Cont’d (2018, December 20). Retrieved from https://www.health.harvard.edu/staying-healthy/the-a-list-of-b12-foods

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27. Non-Pharmacologic Treatment 28 Cont’d Rachael Link. (2018, May 22). Retrieved from https://www.healthline.com/nutrition/foods-high-in-folate-folic-acid

28. Pharmacologic Treatment Folic acid 29 Cont’d UpToDate . ( n.d. ). Retrieved from https://www.uptodate.com/contents/folic-acid-drug-information?search=folic%20acid&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

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30. Treatment Guideline 31 Besarab , A., Coyne, D. Iron supplementation to treat anemia in patients with chronic kidney disease.  Nat Rev Nephrol   6,  699–710 (2010). https://doi.org/10.1038/nrneph.2010.139 Cont’d

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32. Pharmacologic Treatment 33 Warda Osama. (2013, May 9). Anemias during pregnancy warda [compatibility mode]. Retrieved from https://www.slideshare.net/OSAMAWARDA/anemias-during-pregnancy-warda-compatibility-mode Cont’d

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34. Anemia in Elderly 35 UpToDate . ( n.d. ). Retrieved from https://www.uptodate.com/contents/ferrous-fumarate-drug-information?search=iron&source=panel_search_result&selectedTitle=1~140&usage_type=panel&display_rank=1 Cont’d

35. Fabiana Busti , atascia Campostrini , Nicola Martinelli . (2014, April 23). Iron deficiency in the elderly population, revisited in the hepcidin era. Retrieved from https://www.frontiersin.org/articles/10.3389/fphar.2014.00083/full Treatment Guideline 36 Cont’d

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37. Anemia in Pediatrics 38 MARY WANG. (2016, February 15). Iron Deficiency and Other Types of Anemia in Infants and Children. Retrieved from https://www.aafp.org/afp/2016/0215/p270.html Cont’d

38. Iron Requirements in Pediatrics 39 MARY WANG. (2016, February 15). Iron Deficiency and Other Types of Anemia in Infants and Children. Retrieved from https://www.aafp.org/afp/2016/0215/p270.html AGE IRON SUPPLEMENTATION OR REQUIREMENT Preterm (< 37 weeks' gestation) infants: 1 to 12 months 2 mg per kg per day supplementation if exclusively breastfed 1 mg per kg per day supplementation if using iron-fortified formula Term infants: 4 to 6 months to 12 months 1 mg per kg per day supplementation if exclusively breastfed Supplementation not needed if using iron-fortified formula Toddlers 1 to 3 years Requires 7 mg per day; modify diet and/or supplement if anemic Children 4 to 8 years Requires 10 mg per day; modify diet and/or supplement if anemic

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40. Punarnavadi Mandura 41 Janmejaya Samal , and Ranjit Kumar Dehury . ( n.d. ). A Review of Literature on Punarnavadi Mandura : An Ayurvedic Herbo -Mineral Preparation. Retrieved from https://www.phcogj.com/article/138

41. Other Herbs 42 Complementary and Alternative Medicine Penn State Hershey Medical CenterAnemia Penn State Hershey Medical Center. ( n.d. ). Retrieved from https://pennstatehershey.adam.com/content.aspx?productid=107&pid=33&gid=000009

42. Patient Education 43

43. Conclusion 44

44. References Musallam KM, Tamim HM, Richards T, Spahn DR, Rosendaal FR, Habbal A, et al. Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet. 2011 Oct 15;378(9800):1396-1407. 41. Corwin HL, Gettinger A, Pearl RG, Fink MP, Levy MM, Abraham E, et al. The CRIT Study: Anemia and blood transfusion in the critically ill--current clinical practice in the United States. Crit Care Med. 2004 Jan;32(1):39-52. Jenny M. Debenito , BCOP; Sarah J. Billups et al. Impact of a Clinical Pharmacy Anemia Management Service on Adherence to Monitoring Guidelines, Clinical Outcomes, and Medication Utilization. (2014, July 1). https://www.researchgate.net/publication/263432856_Impact_of_a_Clinical_Pharmacy_Anemia_Management_Service_on_Adherence_to_Monitoring_Guidelines_Clinical_Outcomes_and_Medication_Utilization/link/54f89a6b0cf28d6deca2bb02/download Complementary and Alternative Medicine Penn State Hershey Medical CenterAnemia Penn State Hershey Medical Center. ( n.d. ). Retrieved from https://pennstatehershey.adam.com/content.aspx?productid=107&pid=33&gid=000009 45

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