Page 42 - Learnwell EVS
P. 42
emia
Treatment
Iron deficiency anaemia
– elemental iron P 2O fo r 3 m o nths .
C hild ren und er 2 y ears: 3 0 m g o nce d aily = 1 / 2 tab/ d ay
C hild ren fro m 2 to 1 2 y ears: 6 0 m g o nce d aily = 1 tab/ d ay
A d ults: 1 2 0 to 1 8 0 m g/ d ay in 2 o r 3 d ivid ed d o ses = 2 to 3 tab/ d ay
o r p referably , give a co m binatio n o f elemental iron (6 5 m g) + folic acid (4 020 µg) P O
– C o m bine with an anthelm inthic
albendazole P O (excep t d uring the first trim ester o f p regnancy )
C hild ren > 6 m o nths and ad ults: 4 0 0 m g as a single d o se
(C hild ren > 6 m o nths but < 1 0 k g: 2 0 0 m g as a single d o se)
or
mebendazole P O (excep t d uring the first trim ester o f p regnancy )
C hild ren > 6 m o nths and ad ults: 2 0 0 m g/ d ay in 2 d ivid ed d o ses fo r 3 d ay s
(C hild ren > 6 m o nths but < 1 0 k g: 1 0 0 m g/ d ay in 2 d ivid ed d o ses fo r 3 d ay s)
Folic acid deficiency anaemia (rarely isolated)
– folic acid P O
C hild ren und er 1 y ear: 0 .5 m g/ k g o nce d aily fo r 4 m o nths
C hild ren o ver 1 y ear and ad ults: 5 m g o nce d aily fo r 4 m o nths
Haemolytic anaemia
– M alaria: iro n is ineffective excep t in p atients with an asso ciated iro n d eficiency . F o r
the treatm ent o f m alaria, see p age 1 3 1 .
– G 6 P D d eficiency : no sp ecific treatm ent; early treatm ent o f infectio ns; sto p any d rugs
susp ected to be causing a reactio n.
Immediately life threatening anaemia
– O xy gen, p articularly fo r child ren.
– T ransfusio n after d eterm inatio n o f blo o d gro up and ty p e and screening fo r H I V ,
hep atitis B and C , sy p hilis, m alaria in end em ic areas. T o d eterm ine the blo o d vo lum e
required and the rate o f transfusio n, see next p age.
Note: the p revalence o f H I V infectio n m ak es screening o f d o no rs vital. If there is no
p o ssibility o f screening, it is up to the p hy sician to weigh the transfusio n risk with the
life o r d eath risk o f no t transfusing the p atient. A ll transfusio ns that are no t strictly
ind icated are strictly co ntra-ind icated .
2 Doses are calculated in elemental iron.
Tablets of 200 mg ferrous sulphate such as those of ferrous sulphate + folic acid contain 65 mg of elemental iron.
300 mg tablets of ferrous gluconate contain 35 mg of elemental iron.
38
Treatment
Iron deficiency anaemia
– elemental iron P 2O fo r 3 m o nths .
C hild ren und er 2 y ears: 3 0 m g o nce d aily = 1 / 2 tab/ d ay
C hild ren fro m 2 to 1 2 y ears: 6 0 m g o nce d aily = 1 tab/ d ay
A d ults: 1 2 0 to 1 8 0 m g/ d ay in 2 o r 3 d ivid ed d o ses = 2 to 3 tab/ d ay
o r p referably , give a co m binatio n o f elemental iron (6 5 m g) + folic acid (4 020 µg) P O
– C o m bine with an anthelm inthic
albendazole P O (excep t d uring the first trim ester o f p regnancy )
C hild ren > 6 m o nths and ad ults: 4 0 0 m g as a single d o se
(C hild ren > 6 m o nths but < 1 0 k g: 2 0 0 m g as a single d o se)
or
mebendazole P O (excep t d uring the first trim ester o f p regnancy )
C hild ren > 6 m o nths and ad ults: 2 0 0 m g/ d ay in 2 d ivid ed d o ses fo r 3 d ay s
(C hild ren > 6 m o nths but < 1 0 k g: 1 0 0 m g/ d ay in 2 d ivid ed d o ses fo r 3 d ay s)
Folic acid deficiency anaemia (rarely isolated)
– folic acid P O
C hild ren und er 1 y ear: 0 .5 m g/ k g o nce d aily fo r 4 m o nths
C hild ren o ver 1 y ear and ad ults: 5 m g o nce d aily fo r 4 m o nths
Haemolytic anaemia
– M alaria: iro n is ineffective excep t in p atients with an asso ciated iro n d eficiency . F o r
the treatm ent o f m alaria, see p age 1 3 1 .
– G 6 P D d eficiency : no sp ecific treatm ent; early treatm ent o f infectio ns; sto p any d rugs
susp ected to be causing a reactio n.
Immediately life threatening anaemia
– O xy gen, p articularly fo r child ren.
– T ransfusio n after d eterm inatio n o f blo o d gro up and ty p e and screening fo r H I V ,
hep atitis B and C , sy p hilis, m alaria in end em ic areas. T o d eterm ine the blo o d vo lum e
required and the rate o f transfusio n, see next p age.
Note: the p revalence o f H I V infectio n m ak es screening o f d o no rs vital. If there is no
p o ssibility o f screening, it is up to the p hy sician to weigh the transfusio n risk with the
life o r d eath risk o f no t transfusing the p atient. A ll transfusio ns that are no t strictly
ind icated are strictly co ntra-ind icated .
2 Doses are calculated in elemental iron.
Tablets of 200 mg ferrous sulphate such as those of ferrous sulphate + folic acid contain 65 mg of elemental iron.
300 mg tablets of ferrous gluconate contain 35 mg of elemental iron.
38
