Paper I
2025 March (Supplementary (SAY)) (2019 Scheme) · 100 marks · 180 min

Question

Enumerate the iron preparations and add a note on the indications of parenteral iron therapy. (3+3)

Q56 marksShort Essays

Answer

Iron preparations

RouteExamples
OralFerrous sulfate, Ferrous fumarate, Ferrous gluconate
Parenteral (IV)Iron sucrose, Ferric carboxymaltose, Iron dextran

Note on indications for parenteral iron therapy

  • Intolerance to oral iron — significant GI adverse effects (nausea, vomiting, constipation) preventing adequate oral dosing.
  • Malabsorption — conditions impairing intestinal iron absorption (e.g. inflammatory bowel disease, post-gastrectomy).
  • Ongoing significant blood loss exceeding oral replacement capacity — where oral iron cannot replenish stores fast enough.
  • Chronic kidney disease with erythropoietin therapy — increased iron demand for erythropoiesis stimulated by erythropoietin, often exceeding oral absorptive capacity.
  • Poor compliance with oral therapy — allows rapid, supervised, high-dose replacement in a single or few visits.

Parenteral iron allows rapid, complete replacement of iron stores (calculated by a formula incorporating body weight and hemoglobin deficit) without relying on gut absorption.

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