2017 HCHB_digital

CONTINUING OTC EDUCATION
Iron
••
Iron deficiency is reasonably common among New Zealand children.
»»
Maori and Pacific Island children are more at risk.
••
Supplements may be appropriate for some customers, but pharmacists should oversee all new
sales to determine need, and refer customers to a doctor for further investigation.
••
Supplements are used to treat people with confirmed iron deficiency from blood tests, or people
at high risk of becoming iron deficient.
Initial assessment
Iron supplementation is not without controversy and is not generally recommended
unless a customer has a formal diagnosis of IDA. Iron supplementation is also
best done under medical supervision as absorption of other nutrients (ie, calcium,
zinc) may be reduced.
Advise customers that iron-rich foods are preferred over supplements and
suggest ways to improve iron absorption from their diet. Refer any customers
with "yes" answers to the Refer to Pharmacist questions to a pharmacist.
Advice for customers
• Lean red meat is the best source of easily-absorbed iron. Chicken, other
poultry, pork and fish also contain easy-to-absorb iron.
• Combine vitamin C rich foods with sources of non-haem iron to increase
absorption (eg, kiwifruit and cereal, beans and tomatoes, tofu and broccoli).
• Combining haem foods with non-haem foods also increases iron absorption
(eg, meat and salad).
• Avoid drinking tea and coffee at mealtimes as they both reduce iron absorption.
• Babies are born with sufficient iron supplies to last for approximately six
months. After that time, iron-rich foods should be gradually added to their
diets to meet their body’s iron requirements.
• Ensure children and teenagers going through growth spurts are getting
enough iron in their diet.
• Iron stores in pregnant women have to serve the increased blood volume of
the mother as well as the needs of the growing baby.
»»
Some pregnant women may be prescribed iron supplements by their doctor;
however, there is controversy regarding routine supplementation.
• Supplemental iron may cause gastrointestinal side effects such as nausea and
constipation.
• Some forms of supplemental iron (eg, heme iron polypeptides, carbonyl iron,
iron amino-acid chelates) may have fewer side effects than ferrous or ferric
salts.
Refer to
PHARMACIST
All customers who have not had a formal diagnosis of iron-deficiency
anaemia (eg, with blood tests) will need to speak to a pharmacist
who should then refer them to a doctor.
The following questions aim to identify customers who would
benefit from further input from a pharmacist. Your initial assessment
may have already provided some answers. Decide if any further
questions still need to be asked and refer any “yes” answers to a
pharmacist.
• Does the person have any other health conditions (eg, heart or
lung problems, immunosuppression, diabetes, haemochromatosis,
is pregnant or breastfeeding)?
• Does the person take any other medication, either prescribed by a
doctor or bought from a shop or supermarket (including herbal/
complementary medications)?
• Is the person a baby or a child?
• Has the person had any other symptoms (eg, joint pain,
unexplained weight loss)?
• Has the person noticed blood in the stools (note that iron tablets
will make the stools look dark)?
• Have the symptoms persisted despite regular iron tablets?
• Is the person an elderly person?
• Are the iron tablets causing unacceptable side effects?
• Does the person have a good reason for wanting iron supplements?
• Is the person unsure of what dosage of iron is needed?
• Does the person have any allergies to medicines?
Locate this icon throughout the Healthcare Handbook.
Then find the corresponding Pharmacy Today and ELearning articles.
Read all three to unleash learning prizes and giveaways!
Page 101