ANEMIA Cynthia Jackevicius B Sc Phm M Sc

ANEMIA Cynthia Jackevicius, B. Sc. Phm. , M. Sc. , FCSHP

Mrs. JP’s drug-related problems

Mrs. JP’s drug-related problems • Mrs. JP is at risk of continuing to experience S and Sx of iron-deficiency anemia (IDA), secondary to not receiving iron therapy • Mrs. JP may be experiencing gastritis and associated blood loss, and therefore IDA, secondary to the use of ASA • Mrs. JP is experiencing heartburn, most likely due to the use of plain ASA

Mrs. JP’s drug-related problems • Mrs. JP has the potential to experience peptic ulcer disease, secondary to the use of ASA, which may not be the most appropriate drug for the management of her headaches. • Mrs. JP may be at risk for osteoporosis and may benefit from prophylactic therapy (RF: thin, post-menopausal)

Mrs. JP’s drug-related problems • Mrs. JP is at risk of continuing to experience S and Sx of iron-deficiency anemia (IDA), secondary to not receiving therapy

Justification of main DRP Mrs. JP is experiencing signs & Sx of irondeficiency anemia • What is anemia?

Justification of main DRP • what is iron-deficiency anemia? • What are some Sx of Fe-deficiency anemia? Chronic onset: recent onset: • other Sx?

Justification of main DRP • What Sx does JP have? • Can it be diagnosed based on Sx alone? • What are some signs of Fe-deficiency anemia?

Justification of main DRP • What are some general causes of Fedeficiency anemia? • Drug-induced causes:

Justification of main DRP • What RF does JP have for Fe-deficiency anemia? • Is she on any drugs that may cause this?

Role of Fe in the body • • Needed for Hgb synthesis daily requirement: serum Fe: ferritin: TIBC: MCV: RDW:

Other Terminology • Macrocytic, microcytic, normocytic: • hypochromic, normochromic:

Justification of main DRP • What are other types of anemia? • Why are these ruled out? • Therefore, justified that Mrs. JP is experiencing signs and Sx of IDA

Justification of main DRP • Justify relationship of S and Sx to drug therapy: secondary to not receiving therapy assumption: treatment is needed - WHY?

Consider treatment options Diet Oral formulations injectable formulations

Consider treatment options Efficacy Onset Side effects

Consider treatment options Drug interactions convenience cost

Anemia Therefore, we have provided justification to state that: Mrs. JP is at risk of continuing to experience S and Sx of iron-deficiency anemia, secondary to not receiving therapy

Anemia • Mrs. JP may be experiencing gastritis and associated blood loss, secondary to the use of regular ASA Does ASA cause gastritis? Does it cause PUD? Do the original signs and Sx for which she is receiving this need Tx? - consider management of her headaches

Anemia • Mrs. JP is at risk of continuing to experience S and Sx of iron-deficiency anemia (IDA), secondary to not receiving therapy • Mrs. JP may be experiencing gastritis and associated blood loss, and therefore IDA, secondary to the use of ASA • Mrs. JP has the potential to experience peptic ulcer disease, secondary to the use of ASA, which may not be the most appropriate drug for the management of her headaches.

Pharmacy Care Plan clinical outcome pharmacotherapeutic endpoints

Pharmacy Care Plan Alternatives and assessment

Pharmacy Care Plan Therapeutic Plan Endpoints

Pharmacy Care Plan Monitoring Plan and follow-up

Common Drug-Related Problems seen in patients with Anemia Lack of response due to: • non-compliance • EC / SR products being prescribed • Interactions with other medications and diet Inadequate duration of therapy