Iron is an essential component of hemoglobin, myoglobin, and certain enzymes. The bone marrow utilizes iron to make hemoglobin, the liver stores iron as ferritin, and the muscles incorporate iron to produce myoglobin. The body requires iron to transport oxygen throughout the body.
A deficiency in iron absorption leads to a decreased production of hemoglobin. Since hemoglobin is responsible for carrying oxygen throughout the body, the patient develops anemia and presents with fatigue and pallor. This drug also prevents iron deficiency associated with pregnancy or chronic blood loss. With iron deficiency anemia, the RBCs are microcytic and hypochromic.
The body's level of iron is regulated by intestinal absorption. Ferrous sulfate may cause GI distress such as heartburn (pyrosis), constipation, diarrhea, and bloating. These symptoms are dose-dependent and typically decrease with continued drug therapy. Patients experiencing constipation may benefit from a stool softener or laxative.
Administering ferrous sulfate increases the body's amount of iron and subsequently affects the GI system's ability to absorb the mineral. Symptoms of GI distress caused by iron preparations include nausea and vomiting. Inform the patient that continued therapy often leads to decreased symptoms.
Although ferrous sulfate may cause dark green or black-colored stools, inform the patient that this is a harmless side effect and not indicative of bleeding.
Iron is best absorbed on an empty stomach. Certain dietary components may chelate iron and prevent it from being absorbed. Patients should thus be instructed not to take this medication with food. However, this will increase the incidence of GI upset. If patients cannot tolerate the increased GI side effects, they can be instructed to take iron with meals to increase medication adherence
Liquid preparations of ferrous sulfate may stain teeth. Instruct the patient to dilute liquid iron preparations with juice or water, administer through a straw, and rinse the mouth after taking the medication.
Since excessive amounts of iron is toxic, accidental or intentional overdose leads to poisoning. Iron preparations should be stored in childproof containers and kept out of reach of children.
Since iron preparations cause GI effects, this medication may worsen symptoms associated with peptic ulcers, ulcerative colitis, and regional enteritis. Patients with these conditions should use this medication cautiously and avoid oral iron preparations.
Antacids decrease the body's ability to absorb iron and should not be taken with ferrous sulfate.
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