Description of Drugs affecting Blood – PST04211 Basic Pharmacology

NTA Level 4 • Semester 2 • PST04211

Description of Drugs affecting Blood

Basic Pharmacology • Source Session/Topic 27
Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability.

Session 27: Description of Drugs affecting Blood

Total Session Time: 60 minutes

Prerequisites

• None

Learning Tasks

By the end of this session students are expected to be able to:

• List indications of drugs affecting blood
• List contraindications of drugs affecting blood
• Describe dose, dosage and course of drugs affecting blood
• List side effects and adverse effects of drugs affecting blood
• Describe interactions and precautions of drugs affecting blood

Resources Needed:

• Flip charts, marker pens, and masking tape
• Black/white board and chalk/whiteboard markers

SESSION OVERVIEW

Activity/

Step Time Content

Method

1 05 minutes Presentation Introduction, Learning Objectives

Presentation/

2 10 minutes Indications of Drugs Affecting Blood

Buzzing

Presentation/

3 10 minutes Contraindications of Drugs Affecting Blood

Brainstorming

Description of Dose, Dosage and Course of

4 10 minutes Presentation

Drugs Affecting Blood

Presentation/ Side Effects and Adverse Effects of Drugs

5 10 minutes

Brainstorming Affecting Blood

Interactions and Precautions of Drugs

6 05 minutes Presentation

Affecting Blood

7 05 minutes Presentation Key Points

8 05 minutes Presentation Evaluation

PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

164

SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning tasks (5 minutes)

READ or ASK students to read the learning objectives and clarify

ASK students if they have any questions before continuing.

STEP 2:Indications of drugs affecting blood (10 minutes)

Activity: Buzzing (5 minutes)

ASK students to pair up and buzz on the following question for 2 minutes

• Mention drugs affecting blood
• What are the indications of drugs affecting blood?

ALLOW few pairs to respond and let other pairs to add on points not mentioned

WRITE their response on the flip chart/board

CLARIFY and SUMMARIZE by using the content below

• Ferrous sulphate: used in management of iron deficiency anaemia
• Folic acid: used in management of anaemia and neuro tube defect
• Hydroxocobalamin: is also known as vitamin B12, it is used in management of

megaloblastic anaemia

• Iron dextran Injection: used in management of iron deficiency anaemia

STEP 3: Contraindications of Drugs Affecting Blood (10 Minutes)

Activity: Brainstorming (5 minutes)

Ask students to brainstorm on the following question:

• What are the contraindications of drugs affecting blood?

ALLOW few students to respond

WRITE their responses on the flip chart/ board

CLARIFY and SUMMARISE by using the content below

PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

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• Ferrous sulphate is not contra-indicated to specific group of individual but should be

given with care to those people with peptic ulcers

• Folic acid is not contra-indicated to specific group of individual but should never be given

alone for pernicious anaemia and other vitamin B12 deficiency states since it may

precipitate subacute combined degeneration of the spinal cord

• Hydroxocobalamin is not contra-indicated to specific group of individual but should not

be given before diagnosis fully established

• Iron dextran Injection is contra-indicated to those with history of allergic disorders

including asthma and eczema, infection, active rheumatoid arthritis, severe hepatic

impairment and acute renal failure

STEP 4: Dose, Dosage and Course of Drugs Affecting Blood (10 minutes)

• Ferrous sulphate

o Dose prophylactic, 1 tablet (200mg) daily; therapeutic, 1 tablet 2–3 times

daily until signs and symptoms disappear

• Folic acid
o Folate-deficient megaloblastic anaemia, by mouth, adult and child over 1 year, 5 mg
daily for 4 months (until term in pregnant women); up to 15 mg daily may be required

in malabsorption state

o Children under 1 year, 500 micrograms/kg daily (max. 5 mg) for up to 4 months; up
to 10 mg daily may be required in malabsorption states
• Hydroxocobalamin

o By mouth, vitamin B12 deficiency of dietary origin, 50–150 micrograms daily taken

between meals children 50–105 micrograms daily in 1–3 divided doses.

o By intramuscular injection, initially 1 mg repeated 10 times at intervals of 2–3 days,
maintenance 1 mg every month
• Iron dextran Injection

o By deep intramuscular injection into the gluteal muscle or by slow intravenous

injection or by intravenous infusion, 50 mg/mL, 2ml ample or calculated according to

bodyweight and iron deficit

o The product is not recommended to children under 14 years

PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

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STEP 5: Side Effects and Adverse Effects of Drugs Affecting Blood

(10 Minute)

Activity: Brainstorming (5 minutes)

Ask students to brainstorm on the following question:

• What are the side effects and adverse effects of drugs affecting blood?

ALLOW few students to respond

WRITE their responses on the flip chart/ board

CLARIFY and SUMMARISE by using the content below

• Ferrous sulphate: Main side effects include;

o Gastro-intestinal irritation can occur with iron salts example ferrous sulphate.

o Nausea and epigastric pain are dose-related and occur with high dose

o Oral iron, particularly modified-release preparations, can exacerbate diarrhea

• Folic acid: Not common, rarely gastro-intestinal disturbances
• Hydroxocobalamin: Main side effects include;

o Nausea, headache, dizziness and fever

o Hypersensitivity reactions (including rash and pruritus) may occur.

o Injection-site reactions

o Hypokalaemia

o Thrombocytosis

o Chromaturia

• Iron dextran Injection: Not common, they may include;

o Nausea, vomiting and abdominal pain

o Flushing, dyspnoea and anaphylactic reactions

o Numbness, cramps and blurred Vision

o Pruritus, and rash;

STEP 6: Interactions and Precautions of Drugs Affecting Blood (5 minutes)

• Ferrous sulphate

o Absorption of Ferrous sulphate is reduced by oral magnesium salts, calcium salts and

zinc

o Ferrous sulphate reduces absorption of ciprofloxacin and other fluoroquinolones,

levodopa, mycophenolates, Penicillamine, bisphosphonates and levothyroxines

• Folic acid; usually does not interact with any specific group of drugs or any individual

drug

• Hydroxocobalamin; usually does not interact with any specific group of drugs or any

individual drug

PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

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• Iron dextran Injection; usually does not interact with any specific group of drugs or any

individual drug

STEP 7: Key points (5 minutes)

• Most drugs which affect blood are used in management of iron deficient anemia and

megaloblastic anemia.

• Oral iron preparation should be given with care because they interact with more drugs

than other preparations

• Iron dextran is not recommended to children under 14 years,
• Folic acid should never be given alone for pernicious anaemia and other vitamin B12

deficiency states

STEP 8: Assessment (5 minutes)

• What are the indication of ferrous sulphate preparation?
• What are the indication of folic acid?
• What are the indication of cyanocobalamin?
• What is the usual dose of iron dextran injection?
• Which drugs interact with oral iron preparations?

PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

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References

Robert L. Talbert, Gary C. Yee, Gary R. Matzke, Barbara G. Wells, L. Michael. 2014.

Pharmacotherapy: a pathophysiologic approach (9th ed.). New York,

McGraw-Hill Education.

Ministry Of Health and Social Welfare. 2013. Standard Treatment Guidelines &

National Essential Medicines List Tanzania Mainland (4th ed.). Dar es

salaam, Tanzania government printers.

Sally S.R, Jeanne C.S. 2000. Introductory Clinical Pharmacology (6th ed) New York,

Lippincott Williams and Wilkins.

School of Pharmaceutical sciences. 2011. Tanzania Pharmaceutical Handbook

(2nd ed.). Dar es Salaam, ARDHI University press.

The Royal Pharmaceutical Society of Great Britain. 2007. Martindale, the Extra

Pharmacopoeia (5TH ed). London, pharmaceutical press.

The Royal Pharmaceutical Society of Great Britain. 2009. British National Formulary

(59th ed). London, BMJ Group and RPS Publishing.

PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

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