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Iron Deficiency Anemia - FCM in brief.pptx

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Kunal Chhattani

This document discusses the treatment of iron deficiency anemia with ferric carboxymaltose (FCM). It begins by defining anemia and iron homeostasis. It then covers the diagnosis of iron deficiency anemia and treatment options. Oral iron is usually first-line but can cause gastrointestinal side effects and issues with compliance. Intravenous FCM is indicated for patients who fail or do not tolerate oral iron, have malabsorption issues, or require a rapid response. The document provides guidelines on diluting and administering FCM intravenously to effectively treat iron deficiency anemia while minimizing risks.

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TREATMENT OF IRON DEFICIENCY ANEMIA WITH FERRIC CARBOXYMALTOSE Dr. Kunal Chhattani MBBS MD DrNB [Clinical Hematology] Hematologist and Hemato-Oncologist, Chhattani Hematology Clinic, Nagpur
ANAEMIA
WHO Cut Offs: M<13g/dl F<12gm/dl Anemia in pregnancy: 1st Trimester Hb< 11 2nd trimester Hb <10.5 3rd trimester Hb<11 Post partum Hb <10
Iron Homeostasis
IRON HOMEOSTASIS 1-2mg of iron absorbed and lost every day Most absorption- Duodenum 2 forms- Ferrous and ferric Ferric iron Ferrous iron at brush border Iron Blood transferrinBone marrow2/3rd in Hb
Storage: 1. Reticulo Endothelial System 2. Liver Key Regulator: Hepcidin Hepcidin blocks Ferroportin Reduced iron absorption from gut and stores
Iron Deficiency Anemia - FCM in brief.pptx
Iron Deficiency Anemia - FCM in brief.pptx
Diagnosis
SCREENING FOR IDA Ferritin <30ng/ml Transferrin saturation <20%.
Iron Deficiency Anemia - FCM in brief.pptx
Iron Deficiency Anemia - FCM in brief.pptx
Treatment
ORAL IRON Ferrous form is better absorbed Most commonly available : Ferrous sulphate, ferrous fumarate, ferrous gluconate, ferrous ascorbate. Any of these is acceptable.
Advantages: Efficacious for most patients Low risk of serious side effects Low cost Disadvantages: GI toxicity Compliance
Iron Deficiency Anemia - FCM in brief.pptx
SOME QUERIES
IV iron
INDICATIONS OF IV IRON Failure/intolerance of oral iron Noncompliance Rapid response required Malabsorption Continuous bleeding
D. Girelli et al 2017
CONTRAINDICATIONS TO IV IRON Pregnancy <12 weeks Lack of facilities of managing allergic reaction Anaphylaxis to any parenteral iron preparation Iron overload
APPROVALS
D. Girelli et al 2017
Iron Deficiency Anemia - FCM in brief.pptx
D. Girelli et al 2017
PARENTERAL IRON STRUCTURE
Iron Deficiency Anemia - FCM in brief.pptx
DILUTION AND DURATION Dilute FCM 500mg in 100ml NS and 1gm in 250ml NS. Concentration of FCM <2mg/ml is not permissible. Infuse 500mg in minimum 6minutes and 1gm in minimum 15minutes Long duration of infusion and excess dilution can lead to destabilization of iron complex and adverse effects
Iron Deficiency Anemia - FCM in brief.pptx
Iron Deficiency Anemia - FCM in brief.pptx
Iron Deficiency Anemia - FCM in brief.pptx

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Iron Deficiency Anemia - FCM in brief.pptx

  • 1. TREATMENT OF IRON DEFICIENCY ANEMIA WITH FERRIC CARBOXYMALTOSE Dr. Kunal Chhattani MBBS MD DrNB [Clinical Hematology] Hematologist and Hemato-Oncologist, Chhattani Hematology Clinic, Nagpur
  • 3. WHO Cut Offs: M<13g/dl F<12gm/dl Anemia in pregnancy: 1st Trimester Hb< 11 2nd trimester Hb <10.5 3rd trimester Hb<11 Post partum Hb <10
  • 5. IRON HOMEOSTASIS 1-2mg of iron absorbed and lost every day Most absorption- Duodenum 2 forms- Ferrous and ferric Ferric iron Ferrous iron at brush border Iron Blood transferrinBone marrow2/3rd in Hb
  • 6. Storage: 1. Reticulo Endothelial System 2. Liver Key Regulator: Hepcidin Hepcidin blocks Ferroportin Reduced iron absorption from gut and stores
  • 10. SCREENING FOR IDA Ferritin <30ng/ml Transferrin saturation <20%.
  • 14. ORAL IRON Ferrous form is better absorbed Most commonly available : Ferrous sulphate, ferrous fumarate, ferrous gluconate, ferrous ascorbate. Any of these is acceptable.
  • 15. Advantages: Efficacious for most patients Low risk of serious side effects Low cost Disadvantages: GI toxicity Compliance
  • 19. INDICATIONS OF IV IRON Failure/intolerance of oral iron Noncompliance Rapid response required Malabsorption Continuous bleeding
  • 20. D. Girelli et al 2017
  • 21. CONTRAINDICATIONS TO IV IRON Pregnancy <12 weeks Lack of facilities of managing allergic reaction Anaphylaxis to any parenteral iron preparation Iron overload
  • 23. D. Girelli et al 2017
  • 25. D. Girelli et al 2017
  • 28. DILUTION AND DURATION Dilute FCM 500mg in 100ml NS and 1gm in 250ml NS. Concentration of FCM <2mg/ml is not permissible. Infuse 500mg in minimum 6minutes and 1gm in minimum 15minutes Long duration of infusion and excess dilution can lead to destabilization of iron complex and adverse effects