Iron preparations: Nursing pharmacology

Iron preparations are medications that contain iron, and can be used to treat iron deficiency anemia. This is defined as a state of low red blood cells or hemoglobin in the blood, which could result from nutritional iron deficiency, chronic kidney disease, blood loss or hemorrhage, and during pregnancy or breastfeeding, in which there’s an increased demand for iron and for red blood cells production.

Most often, iron preparations can be given orally, such as ferrous sulfate, ferrous gluconate, and ferrous fumarate.

In clients who don't tolerate oral iron preparations for their side effects or because of gastrointestinal malabsorption, iron preparations can be given intravenously, such as iron sucrose and ferumoxytol, as well as intramuscularly, such as iron dextran.

Now, most of the iron in oral preparations is lost with stool, while some of it is stored inside the intestinal cells as ferritin.

When the body’s iron demand increases, active transport channels shuttle this stored iron to the blood, where it binds to its carrier protein, transferrin.

On the other hand, intravenous and intramuscular iron preparations bypass intestinal absorption and go straight to the blood.

Regardless of the route of administration, once iron is in the blood, it can then be stored inside macrophages as ferritin, or transported to various tissues like the bone marrow, where it’s used for hemoglobin synthesis, and ultimately for red blood cell production.

Now, the main side effects of oral iron preparations include metallic taste, temporary staining of teeth enamel as well as gastrointestinal symptoms such as nausea, vomiting, abdominal pain, flatulence, constipation, and dark stools.