FERRO DROPS 77.328MG/0.6ML SOLUTION

Indications

• Iron deficiency anemia
• Prevention of iron deficiency in at-risk populations
• Anemia of chronic disease

Dosage

Children: Refer to appropriate clinical guidelines or consult the BNF for Children for specific dosing recommendations based on age and weight.

Adults: Refer to appropriate clinical guidelines or consult the BNF for specific dosing recommendations based on the clinical condition being treated.

Mechanism of action

Ferrrous iron is absorbed in the duodenum and proximal jejunum of the intestine. Once absorbed, it is utilized in the synthesis of hemoglobin and myoglobin, and it is also involved in various enzymatic reactions as a cofactor. The presence of ascorbic acid (vitamin C) can enhance the absorption of ferrous iron by reducing it from ferric (Fe3+) to ferrous (Fe2+) form.

Pharmacodynamics

Iron is crucial for the production of red blood cells and is involved in oxygen transport. It is also a component of various enzymes necessary for metabolism and cellular function. The body regulates iron levels tightly, with a storage form (ferritin) that releases iron as needed to maintain homeostasis. Excess iron can lead to toxicity, particularly in individuals with certain genetic conditions.

Pharmacokinetics

After oral administration, ferrrous iron is primarily absorbed in the small intestine, with absorption rates varying based on dietary factors and iron stores in the body. The average absorption rate is about 10-15% for ferrous iron. Iron is transported in the bloodstream bound to transferrin, and it can be stored in the liver, spleen, and bone marrow as ferritin. The half-life of iron in circulation is relatively short, and the body has no active excretory mechanism for iron, relying instead on regulation of absorption.

Contra-indications

• Hypersensitivity to ferrous formulations
• Hemochromatosis
• Hemosiderosis
• Iron overload syndromes
• Certain types of anemia not responsive to iron

Adverse effects

• Gastrointestinal disturbances (nausea, vomiting, constipation, diarrhea)
• Abdominal pain
• Dark stools
• Teeth staining (liquid formulations)
• Allergic reactions (rare)

Interactions

• Antacids may reduce absorption of iron
• Tetracyclines and fluoroquinolones may have decreased efficacy when taken with iron
• Vitamin C may enhance iron absorption
• Chloramphenicol may decrease the effectiveness of iron

Precautions

• Use with caution in patients with peptic ulcer disease
• Monitor for signs of iron overload in long-term therapy
• Assess gastrointestinal tolerance before continuous use
• Consider dietary factors that may affect absorption

Pregnancy

Iron is essential during pregnancy for fetal development and to prevent anemia. It should be used as directed by a healthcare provider.

Breast-feeding

Iron supplementation is generally considered safe during breastfeeding, but should be discussed with a healthcare provider.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children due to the risk of overdose.

Formulations

• Ferrous sulfate
• Ferrous gluconate
• Ferrous fumarate
• Liquid iron supplements

Indications

• Metabolic acidosis
• Lactic acidosis
• Energy substrate in critical illness
• Monitoring tissue perfusion and oxygenation

Dosage

Children: Refer to the BNF for Children for appropriate dosing in paediatric patients.

Adults: Refer to specific guidelines based on clinical context as dosing is highly variable and situation-dependent.

Mechanism of action

Lactate acts as a signaling molecule and energy substrate in various physiological and pathological processes. It is involved in the modulation of several metabolic pathways, including the Cori cycle and Krebs cycle. Lactate also participates in metabolic reprogramming, especially in cancer cells, where it can promote tumor growth and survival by providing an alternative energy source and influencing cellular signaling pathways such as the PI3K/AKT/mTOR pathway.

Pharmacodynamics

Lactate plays a vital role in energy metabolism. It can be oxidized back to pyruvate by lactate dehydrogenase, entering the Krebs cycle for ATP production. In addition to serving as an energy substrate, lactate impacts pH regulation and can influence the function of various immune cells. Its levels can indicate the state of oxygen delivery and utilization in tissues, thus serving as a marker for metabolic stress.

Pharmacokinetics

Lactate is produced primarily in the cytoplasm during glycolysis, with its concentration in the blood reflecting the balance between production and clearance. It is metabolized predominantly in the liver, where it can be converted back to glucose or utilized in the Krebs cycle. Lactate levels can vary based on factors such as exercise, tissue hypoxia, and metabolic conditions.

Pregnancy

Lactate is generally regarded as safe during pregnancy as it is a naturally occurring metabolite in the body, but specific clinical advice should be sought.

Breast-feeding

Lactate is considered safe during breastfeeding as it is a normal component of human metabolism, but consult a healthcare provider for personalized advice.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.