First sign of improvement in oral iron therapy is?
ANSWER: (A) Reticulocytosis REF: Harrison's 18th ed ch: 103Monitoring iron therapy:Clinically, the effectiveness of iron therapy is best evaluated by tracking the reticulocyte response and the rise in the hemoglobin or the hematocrit.An increase in the reticulocyte count is not observed for at least 4 to 7 days after beginning therapy. A measurable increase in the hemoglobin level takes even longer.A decision as to the effectiveness of treatment should not be made for 3 to 4 weeks after the start of treatment.An increase of 20 g per liter or more in the concentration of hemoglobin by that time should be considered a positive response, assuming that no other change in the patient s clinical status can account for the improvement and that the patient has not been transfused.A few important points about oral iron therapy:According to good man gillman the oral drug of choice for iron deficiency anemia is ferrous sulfateRemember ferrous sulfate contains 32% elemental iron and ferrous fumarate contains 33% elemental ironiron usually is absorbed in the upper small intestineTypically, for iron replacement therapy, up to 300 mg of elemental iron per day is given, usually as three or four iron tablets (each containing 50-65 mg elemental iron) given over the course of the day. Ideally, oral iron preparations should be taken on an empty stomach, since food may inhibit iron absorptionThe goal of therapy in individuals with iron-deficiency anemia is not only to repair the anemia, but also to provide stores of at least 0.5-1 g of iron. Sustained treatment for a period of 6-12 months after correction of the anemia will be necessary to achieve this.Of the complications of oral iron therapy, gastrointestinal distress is the most prominent and is seen in 15-20% of patients
Reticulocytosis
Raise of hemoglobin
Raise in RBC count
Increase in ESR
Iron Deficiency and Megaloblastic Anemia