Anemia Essay Samples

Anemia is a condition in which the red blood cells have a diminished capacity to carry oxygen. Although there are different causes of anemia, they fall into one of the following categories, such as blood loss due to hemorrhage, increased erythrocyte destruction and impaired erythrocyte production . As anemia progresses, the patient exhibits pallor, paleness of skin and mucous membranes due to the deficiency of hemoglobin. Decreased exercise tolerance, fatigue and lethargy occur as insufficient oxygen reaches the muscles. Dizziness and fainting are common symptoms of anemia as the brain does not receive enough oxygen to function properly. The respiratory and cardio-vascular systems compensate for oxygen depletion by increasing the rates of respiration and heartbeat . Chronic and severe anemia can also result in heart failure.
Depending on the type of anemia, the patient requires several vitamins and minerals to enhance the oxygen-carrying capacity of the blood. The most common anti-anemic agents are cyanocobalamin, folic acid and ferrous sulfate . Vitamin B12 and folic acid are dietary nutrients necessary for rapidly dividing the cells. The most common cause of vitamin B12 deficiency in anemic patients is due to the absence of intrinsic factor, a protein secreted by the stomach cells. Folic acid or folate is a B-complex vitamin essential for normal synthesis of DNA and RNA . The most common cause of folic acid deficiency is insufficient dietary intake. It is a common scenario in chronic alcoholism as alcohol interferes with the folate metabolism in the liver. Dietary intake of folic acid through fresh green vegetables, dried beans and wheat products helps to prevent anemia caused by the deficiency of folic acid.
Pharmacotherapy involves the administration of cyanocobalamin, which is the purified form of vitamin B12. Though oral supplements of cyanocobalamin are available, they are effective only in patients who have sufficient intrinsic factor. Parenteral administration of cyanocobalamin reduces the symptoms of anemia within a few days or weeks. However, the drug is not effective in anemia caused due to the deficiency of iron. Also, the drug is a contra indicator in patients suffering from pulmonary disease. It is important to monitor the serum potassium levels periodically during pharmacotherapy as hypokalemia is a possible side effect of the drug . It is also essential to monitor the cardiovascular status of the patients as the drug may also develop pulmonary edema and heart failure in some cases.
In the case of iron-deficiency anemia, pharmacotherapy involves the administration of oral iron supplements, such as ferrous sulfate, ferrous gluconate and ferrous fumarate. Slow-release products, such as carbonyl iron are expensive, but less dangerous in terms of toxic effects. Ferrous sulfate is a contra indicator in patients suffering from hemolytic anemia, without documenting the conditions of peptic ulcer, ulcerative colitis, regional enteritis and hemochromatosis . Iron dextran is a parenteral iron supplement given in the form of IM injection or IV infusion to reduce the symptoms of iron-deficiency anemia. The antidote for acute iron intoxication is deferoxamine, which when removed by the kidneys turns the urine to a reddish-brown color.
In addition to the administration of the drugs, it is essential to advise the patient to rest for longer hours to conserve energy as diminished iron levels result in decreased formation of hemoglobin, leading to weakness and fatigue. The patient should increase the intake of iron-rich foods, such as liver, egg yolks, wheat germ and muscle meats. In some cases, the drugs may cause constipation, change in the color of the stool to dark green color and false positives in stool tests for occult blood . To relieve constipation caused by the drug, the patient’s diet should include high-fiber vegetables and grains, and fluids. It is important to advise the patient on excess intake of iron supplements as they may be very toxic in nature and cause severe side effects.

References

DiPiro, J., Talbert, R. L., Yee, G., Matzke, G., Wells, B., & Posey, L. M. (2011). Pharmacotherapy: A Pathophysiologic Approach, Eighth Edition. McGraw Hill Professional.
Patrick, A. M. (2008). Pharmacology for Nurses. Pearson Education India.