Iron-deficiency anemia

Iron deficiency anemia is the shortage of iron in the body, which is part of a complex of the protein hemoglobin. Hemoglobin is found in red blood cells (erythrocytes) and consists of globin protein and attached to it the iron (heme). When arterial blood passes through the lungs, the hemoglobin captures oxygen and delivers it to various organs and tissues. Having oxygen hemoglobin adds carbon dioxide that is already in the venous blood enters the lungs and excreted.

When iron deficiency (such a state can occur if the wrong diet, frequent bleedings, etc.) and the quantity of hemoglobin decreases, and hence does not flow into the tissue the required amount of oxygen. Without oxygen, it is impossible to exercise metabolism, so the state of the tissues affected. Oxygen deficiency primarily affects the brain, which is especially sensitive to its scarcity, but also in other organs various changes occur that affect the status of patients. There are lethargy, fatigue, constant malaise, fainting and so on. Compensate for iron deficiency anemia in the already developed only nutrition is impossible, iron must be obtained in the form of drugs.

The mechanism of action Sorbifer durules

Sorbifer durules - protivoanemicheskim combined preparation which comprises a salt of iron (ferrous sulfate), and ascorbic acid. Ferrous sulfate compensates for the deficiency of iron in the body, which is necessary for the functioning of the body: it is part of the hemoglobin and some other cells, carries oxygen to the tissues, is involved in a number of redox reactions, stimulates the production of red blood cells.

Ascorbic acid enhances iron absorption in the intestine. Manufacturing process Sorbifer durules formulation provides long (prolonged for 6 hours) the release therefrom of ferrous ions, which promotes small concentration of ferric ions in the stomach and intestines. This is important since the iron ions are irritating to the mucosa of the gastrointestinal tract.

When administered drug is well absorbed (mainly in the duodenum), binds to plasma proteins and is deposited in the liver and in the muscles where necessary, as is supplied for the formation of hemoglobin.

In exchange reception Sorbifer durules gradual disappearance of clinical and laboratory signs of anemia.

Indications and contraindications for use

Sorbifer durules prescribed for laboratory-confirmed iron deficiency anemia and its prevention during pregnancy, breast- Breastfeeding - a personal choice   breast and donors who donate blood regularly. In exchange application of the drug treatment is carried out under the mandatory laboratory control.

Contraindications reception Sorbifer durules are hypersensitive to the drug, the narrowing (stenosis) of the various parts of the gastrointestinal tract, high content of iron in the body, disrupting the absorption of iron in the body and for children up to 12 years (clinical studies in children have not been conducted).

With care use in patients with gastric ulcer and duodenal ulcers, inflammatory bowel disease Inflammatory Bowel Disease: Symptoms and Treatment Especially ulcerative lesions of the colon.

Should not be taken simultaneously with Sorbifer durules certain antibiotics (e.g. tetracycline) and with means lowering gastric acidity, because they interfere with the absorption of iron. Absorption of the drug is also reduced when receiving a black tea, coffee, milk solids, corn and eggs. Not recommended before taking this medication, eating fatty foods.

Overdose and side effects

If overdose can occur abdominal pain, nausea, vomiting, fatigue or weakness, fever, numbness, and tingling in the body (paresthesia), pale skin, rapid heartbeat. In such cases, you should wash the stomach, to bind iron ions to drink milk or eat a raw egg and seek medical attention for the appointment of a special treatment, contributing to neutralize the iron.

When receiving Sorbifer durules can also have some side effects: nausea, vomiting, abdominal pain Abdominal pain: Types and Symptoms Diarrhea or constipation, ulcerative lesion of the esophagus, esophageal stenosis, allergic reaction (itching, rash), headache, dizziness Dizziness - if the ground is slipping from under his feet Weakness, feces may become black.

Sorbifer durules refers to drugs that can be prescribed only by the doctor.

Galina Romanenko

Anticoagulants direct and indirect action

Anticoagulants - a group of drugs that lowers the rolling properties of the blood, preventing the formation of fibrin in it (water-insoluble protein formed in blood clotting). Anticoagulants prevent clots and contribute to the cessation of growth of blood clots that have already arisen. They are divided into anticoagulants of direct and indirect action. Anticoagulants direct (quick and short-term, for example, heparin) act directly on the clot (thrombus) and indirect (long, for example, neodikumarin) actions activate a special (fibrinolytic) system of blood clot dissolution.

What fraxiparine and its mechanism of action

Fraksiparin (international non-proprietary name - nadroparin calcium) - is a direct anticoagulant action, which is a low molecular weight heparin is prepared from standard heparin. The average molecular weight of 4300 Daltons fraxiparin, while the average weight of conventional heparins is 12000-16000 Daltons. Low weight allows fraxiparine more actively bind to plasma proteins (antithrombin III) and rapidly inhibit the activity of the blood clotting factors (eg coagulation factor Xa). Furthermore, fraksiparin acts on other blood coagulation factors, e.g., it helps to reduce the viscosity of the blood and prevents agglutination of blood platelets.

Unlike conventional heparin it is longer-acting and preventive doses causes no significant decrease APTT (activated partial thromboplastin time - the time in which a blood clot formed after joining the plasma of some of the reagents; this is the most accurate measure of blood clotting).

Indications for use

Fraksiparin can be administered for the treatment and prevention of blood clots.

For treatment fraksiparin used in the treatment of thromboembolism (when clot occludes a blood vessel).

For the prevention of thrombosis fraxiparine used for:

• against the backdrop of surgery;
• with the threat of blood clots (e.g., coronary heart disease, including myocardial infarction Myocardial infarction - the most formidable diagnosis , With varicose veins, etc.);
• during hemodialysis Hemodialysis: artificial kidney   (blood purification).

Contraindications for use

Fraksiparin should not be used:

• hypersensitivity to fraxiparine;
• at elevated bleeding and tendency to bleeding;
• an exacerbation of gastric ulcers and 12 duodenal ulcer;
• trauma, intracranial hemorrhage or surgical interventions on the eyes and central nervous system;
• purulent inflammation of the inner lining of the heart (bacterial endocarditis);
• with insufficient blood platelets, which are one of the clotting factors;
• with severe renal dysfunction;
• Pregnancy and breast-feeding Breast-feeding: feed - and no nails! ;
• If the patient has not reached the age of 18 years.

Precautions should be prescribed fraxiparine in the human liver and kidneys, with very high blood pressure Blood pressure - dangerous if his swing? In the presence of last relapse of gastric ulcer and 12 duodenal ulcers, disorders of blood circulation in the eye area.

Side effects

Fraksiparin can cause a number of side effects:

• by coagulation - bleeding and decrease the number of platelets;
• on the part of the digestive system - a temporary, a transient liver dysfunction;
• allergic reactions - redness and itching at the injection site, urticaria, angioedema, anaphylactic shock (very rare);
• Local reactions - bruising, seal the injection site.

Overdose

With prolonged use of high doses of fraxiparin possible occurrence of various bleeding, particularly in patients at risk (including elderly patients, renal failure). Minor bleeding do not require discontinuation of the drug - enough to reduce the dose.

Know the principles of anticoagulants is worth at least to never use them at its discretion without a prescription.