Intravenous iron pharmaceutical not only cures anaemia

Intravenous iron pharmaceutical not only cures anaemia
Intravenous iron pharmaceutical not only cures anaemia
Fudan University subsidiary the intersection of Huashan and the intersection of hospital and the intersection of hematology and chief physician let Goetsch wait initially intravenous to employ hydrogen to oxidize irons and treat low pigment nature anaemia little flat 1946. Over half a century and more, intravenous to mend iron, receive increasingly many to pays attention to and is employed extensively, more effective, more safely, more convenient intravenous iron preparation is emerging constantly. Intravenous iron pharmaceutical is divided into six kinds at present the world offer up a sacrifice there are six kinds of intravenous iron pharmaceuticals of clinical practice: Low molecular the intersection of dextrose and the intersection of anhydride and iron, the intersection of macromolecule and the intersection of dextrose and the intersection of anhydride and iron, the intersection of glucose and sour the intersection of iron and sodium, the intersection of cane sugar and iron, ferumoxytol and carboxyl malt sugar iron. Among them ferumoxytol was authorized through FDA at the end of 2009, the carboxyl malt sugar iron has already been listed on some of Britain,etc. European country now, U.S.A. is still in the examination. The dextrose anhydride iron occupies an leading position for a long time in our country, but the clinical practice of the cane sugar iron has already shown a tendency to obviously rise in recent years. Intravenous after mending irons, there is much ferritin of serum to obviously enter and up to peak value within several days, the degree of saturation of serum transferrin resumes rapidly, the left and right network weaves the quantity of erythrocyte and rises in 8 days. Regard degree of saturation of ferritin and transferrin as, mend the intersection of iron and index of following up a case by regular visits to on being at present clinical. Someone proposes, generally speaking the ferritin of serum is less than 600ng/ml comparatively safe, if the ferritin needs to watch out for the iron overload in above 1000ng/ml for a long time. Four applicable at the clinical iron deficiency anemia disease, iron deficiency anemia diagnose establish and find out behind the cause of disease should mend the iron treatment immediately ing. Generally speaking, oral iron pharmaceutical is first-selected, but oral iron pharmaceutical often initiates the obvious gastrointestinal tract uncomfortable, it is reported nearly 1/5 of the patients stop treating because of this. Oral iron pharmaceutical is still influenced by the fact that interfering with and internal iron of the food composition stores. Especially a lot of chronic disease and tumour patient, absorption and use of the iron will be influenced. As to this part of patients, the clinician should consider offering intravenously and mending irons. In addition iron deficiency anemia accompany patient, intestines problem of stomach, need fast to resume internal iron stock and take orally enoughly up to this goal, can also mend being intravenous the iron as choosing first. Intravenous iron pharmaceutical can be calculated according to the following formulae while mending the iron dosage: Mend the accumulating amount of iron (element iron; mg) =Weight (kg) *[Hemoglobin goal value- Surveying value (g/L) ]*0.24+ amount of iron stored (amount of iron stored: Weight> 35kg person is 500mg, <35kg person calculates with 15mg/kg weight) . The chronic renal failure patient of kidney trouble often needs to urge the erythrocyte to produce preparations and unite intravenous iron pharmaceutical to treat. The American kidney trouble foundation made in 2006 " Kidney trouble survives quality is guided " Point out, as to chronic kidney trouble (CKD) The patient requires the ferritin of serum> 200ng/ml (blood completely) > 100ng/ml (belly dialyse the persons who rely on non- completely) ,Require the intersection of transferrin and degree of saturation> 20% at the same time, the patient gives a recommendation employing intravenous iron pharmaceutical strongly completely to blood. In recent years, require that it is stronger and stronger to dialyse the voice that first chooses to employ intravenous iron pharmaceutical in the persons who rely on completely and in the belly. About 55% of the chronic hearts of heart disease have anaemia to decline a patient at the same time, anaemia can cause the blood platelet to increase, increase energies, run affairs emergence of one. A lot of research shows, urge red plain and intravenous iron pharmaceutical to unite application, can raise hemoglobin previously, improve symptom, increase the able to bearing amount of sports. Bolger,etc. prove, use intravenous iron pharmaceutical separately ' Cane sugar iron) Also can obtain the good result, but the case is counted and lacked (only 17) ,And not set up the control group. Recently Anker,etc. to loud sample quantity ' 459) The prospective random controlled study of many centres that the chronic heart disease patient carries on shows, the carboxyl malt sugar iron can improve symptom, function to store and quality lives to treat to use separately, and the side effect can accept. Patient, tumour of tumour, because many kinds of factor but companion send anaemia, can only often rely on urging the erythrocyte to turn into preparation, blood transfusion and intravenous iron pharmaceutical treatment at being clinical often. Can promote tumour to grow while producing preparations while urging the erythrocyte, increase the probability of recuring, or cause thrombosis,etc.. Bohlius,etc. analyzes that finds, urges the erythrocyte to produce preparations to really make tumour patient's mortality increase by 10%~17%. In addition, transfusing blood repeatedly is thought extensively too that will reduce the organism immunological function, increase the probability that tumour recurs. More than one centre prospective research abroad shows in 2008, will complement in the patient accepting bone-marrow transplantation at lymphoma with intravenous iron pharmaceutical, can in order to being more low dose ofly to urge the erythrocyte to turn into preparations to enable hemoglobin up to goal value within shorter time. Scholar's research of 44 gynecological tumour patients who accept pharmaceutical chemotherapy of platinum shows, it can be apparent that intravenous to mend irons to reduce the reliance on blood transfusion. Chain the bad reaction and prevent the allergic response Serious irritated incident such as anaphylactic shock, breathe, delay, wheeze even die, probability happens while employing the dextrose anhydride iron higher, is up to 0.6% to 0.7%. This dosage form has been already inactive in Europe at present. Employ the intersection of dextrose and anhydride demand, go ahead of the rest 25mg test while being low dose of, observe, have, can continue using behind the obvious bad incident 60 minute in front of the iron. Only 0.04% of probability of this kind of allergic incident happens in the sour iron of glucose, and the cane sugar iron may be lower, seem not to see that there are case reports of death, so the two do not generally need to test before using medicine. Other allergic can deal with diphenhydramine, Epinephrine,etc. to the ill. Should defy and be infected with and can be caused and should defy to oxidize while catalyzing the active free iron to oxidize, cause lipid to cross and oxidize, and then produce more free radicals and urge the inflammation material; And the free iron is that the bacterium grows and breeds important nutritive pharmaceutical, and can reduce the leucocyte function, so have the opportunity to may know and increase and is infected with. Drip speed in regular dosage, glucose sour iron have transferrin pass saturated phenomenon seldom, the free iron release amount can nearly be ignored. And the supersession route is different in the body of cane sugar iron, some free irons can be entered in blood directly, will increase and oxidize the risk that should defy and infect. Can employ ascorbic acid, lycopene,etc. to reduce and oxidize and should be surged and damaged.


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