Florida National University Diagnostic Approach to Iron Deficiency Discussion

The specific goal of treating M.W is to increase the hemoglobin level that works best for him. Another goal is to increase the oxygen level that his blood carries. Another goal of treating M.W is to treat the underlying causes of anemia. The underlying causes of anemia include a shortage of iron in the body; this can be prevented by taking iron tablets. Secondly, the bone marrow needs to make iron, and without iron, the body cannot produce enough hemoglobin for the red blood cells.

Question 2

The drug therapy I would prescribe includes the treatment with recombinant human erythropoietin called epoetin alpha. The starting dose of epoetin is 50 to 100 units /kg. It is given subcutaneously three times a week for hemoglobin < 10g/dl until the hemoglobin target of 11.0 to 12.0g/dl is reached (Siddappa et al., 2020). I recommend this drug therapy because it promotes the production of red blood cells in the bone marrow. It helps in producing red blood cells that aids in carrying oxygen from the lungs to the rest of the body. Erythropoietin is injected into the body to induce the production of red blood cells. The bone marrow is stimulated to produce red blood cells. Drug therapy is essential because it aids in the production of enough oxygen for the body.

Question 3

The parameters for monitoring the therapy’s success include taking a blood test whereby the red blood cells count is taken. The patient should maintain a high level of iron that can improve effective erythropoiesis. The target range of hemoglobin can show the effectiveness of the therapy. It is essential to acquire the life of the patient.

Question 4

The patient should understand that too much use of erythropoietin could result in severe contraindications; taking a single extra dose could promote a lot of concern. An overdose of the drug could result in adverse side effects. These adverse effects could include arthralgia, bronchospasm, cough, dizziness, heart failure, hypertension, and angioedema. Patients must ensure that they visit the doctor for a blood test and to check their blood pressure. Patients should know that the dose given depends on the oxygen level of the patient. The patient must implement strategies that ensure that his hemoglobin level is between 10.5-11.5g/dl. The patient should know that the dozing could change depending on the level of hemoglobin.

Other adverse effects that the patient should understand include headache, fever, hypokalemia, infection, myalgia, thrombosis, seizures, vomiting, cerebrovascular events, cardiovascular events, and urticarial (Salamin et al., 2018). The patients should also learn that he should not use Epogen when experiencing uncontrolled blood pressure.

Question 5

Erythropoietin could result in increased blood pressure; this could force the doctor to change to another therapy. If blood pressure is worsened, the doctor could change the therapy. An increase in blood pressure results from an increasing number of red blood cells. Another therapy could be preferred to help lower blood pressure. The drug therapy could also result in irritation and pain on the injection site. If drug therapy is used for too long, the body could start making antibodies that fight against it; thus, its use must be stopped. At some point, allergic reactions could occur due to the medication.

Question 6

The over-the-counter medications that M.W can use include ferrous sulfate that aids in treating patients with iron deficiency. The drug can be used for a period of 2 months after the correction of anemia. Another medication could be iron supplements such as iron tablets that help maintain a high level of iron in the body. Iron supplements can be taken for several months to ensure a constant level of iron in the body.

Vitamin B-12 or folate is an over-the-counter medication for anemia. The use of vitamins helps the body to increase the production of red blood cells. M.W must take these supplements for a longer period of time to promote enough production or red blood cells to facilitate oxygen distribution in the body. The supplements also have their side effects; thus, they can cause dizziness, nausea, and vomiting. All these drugs are cheap and can help to maintain a high blood cell. The transfusion is essential to increase hemoglobin in the body.

Question 7

The dietary changes recommended for M.W include eating a healthy diet that is made of green-dark vegetables, nuts and seeds, seafood, meat, and beans can also be recommended for M.W. apart from that, vitamin C rich fruits and vegetables are also recommended for M.W (Elstrott et al., 2020). iron-fortified dresses, bread, and pasta should be taken by M.W. Lean red meat is the best source of an easily absorbed iron. Chicken and fish are good sources of heme iron.

The lifestyle changes recommended for M.W include weight loss. M.W should devote enough time to exercise and eat healthy food with few calories. He should also take a low sodium diet. Weight loss could reduce the risk of hypertension and other heart diseases. He can begin by walking or running to keep the body active and eliminate a few pounds. A low-phosphate diet is also recommended for M.W. He should always be active to ensure effective metabolism that could prevent fat accumulation in the body.

References

Elstrott, B., Khan, L., Olson, S., Raghunathan, V., DeLoughery, T., & Shatzel, J. J. (2020). The role of iron repletion in adult iron deficiency anemia and other diseases. European journal of haematology, 104(3), 153-161.

Salamin, O., Kuuranne, T., Saugy, M., & Leuenberger, N. (2018). Erythropoietin as a performance-enhancing drug: its mechanistic basis, detection, and potential adverse effects. Molecular and cellular endocrinology, 464, 75-87.

Siddappa, A. M., Olson, R. M., Spector, M., Northrop, E., Zamora, T., Brearley, A. M., … & Rao, R. (2020). High prevalence of iron deficiency despite standardized high-dose iron supplementation during recombinant erythropoietin therapy in extremely low gestational age newborns. The Journal of Pediatrics, 222, 98-105.