Drug name Classification Mechanism of action Indication Contraindication Adverse reaction Nursing responsibilities

Generic Name Ferrous Sulfate Treatment of Hemochromatosis, Before

Feratab Acts to normalize RBC
production by
binding with hemoglobin or
by being
Brand Name oxidized and stored as
Feratab hemosiderin or
aggregated ferritin in
reticuloendothelial
cells of the liver, spleen,
Actual dosage, route, and bone marrow.
frequency Iron is an essential
component of hemoÂ
PO: ADULTS, globin, myoglobin, and
ELDERLY: 30–60 several enzymes,
mg/day. CHILDREN: including cytochromes,
(5–12 yrs): 30–60 catalase, and
mg/day. (2–4 yrs): 30 peroxidase. Iron is needed
mg/day. (6 mos–1 for catecholamine
yr): 10–12.5 mg/day metabolism and normal
neutrophil
ADULTS, ELDERLY: function.
65–200 mg/day in 2–
3 divided doses.
CHILDREN: 3–6
mg/kg/day in 2–3
divided doses. I
megaloblastic hemolytic anemia’s, CNS: Dizziness, fever,
anemias due to a hemosiderosis, headache, - BASELINE ASSESSMENT
deficiency of folic hypersensitivity to iron paresthesia, syncope
acid as may be salts or their -Assess nutritional status, dietary
seen in tropical or components, other CV: Chest pain, history. Question history of
non-tropical sprue, anemic conditions unless hypertension, hemochromatosis, hemolytic
in anemias of accompanied by iron hypotension, anemia, ulcerative colitis. Question
nutritional origin, deficiency. tachycardia use of antacids, calcium
pregnancy, supplements.
infancy, or Patients with Dermatologic:
childhood. hemochromatosis, Diaphoresis, flushing, During
hemosiderosis or pruritus, rash, - Give iron tablets and capsules
hemolytic anemia urticaria with a full glass of water or juice.
A reduced form of Don’t crush enteric coated tablets
folic acid known as EENT: Metallic taste, or open capsules.
citrovorum factor tooth discoloration
(or leucovorin) is -Because iron solutions may stain
given to replenish Endocrine: Dyspnea, teeth, dilute and administer with a
endogenous folic wheezing straw or place drops in back of
acid in patients on patient’s throat. Mix the elixir form
methotrexate GI: Abdominal cramps, in water. Fer-In-Sol Drops or
(which inhibits constipation, Syrup may be mixed with water or
dihydrofolate epigastric pain, nausea, juice.
reductase). stool discoloration,
Citrovorin vomiting - Monitor patient’s blood pressure
(leucovorin) is after each intravenous dose for
better absorbed Hematologic: significant increases, as
compared to folic Hemochromatosis, hypertension may occur
acid. hemolysis, hemosiderosis immediately after administration
but usually resolves within 30
 minutes.
Other: Anaphylaxis (with
I.V. administration),
angioedema, injection
site discoloration
After

- Advise patient to consult

prescriber before taking large
Source : Saunders Nursing amounts of iron for longer than 6
drug Handbook 2021 by months.
Robert J. Kezoir and Keith
Hodgson -Warn patient about high risk of
Accidental poisoning, and urge her
to keep iron preparations out of
the reach of children.

Drug name Classification Mechanism of action Indication Contraindication Adverse reaction Nursing responsibilities
Generic Name Folic Acid -Treatment of Hypersensitivity to CNS: stomach upset, nausea, Before:
Folvite Acts as a catalyst for normal megaloblastic anemias folic acid or its diarrhea, irritability, confusion, - BASELINE ASSESSMENT
production of red blood cells, due to a deficiency of Components. behavior changes, skin reactions, Pernicious anemia should be ruled
helping to prevent megalo folic acid as may be seen seizures, and other side effects. out with Schilling test and vitamin
blastic anemia, and helps in tropical or non- Folic acid should B12 blood level before initiating
Brand Name maintain normal tropical sprue, in not be given alone CV: Hypotension, , HPN and heart therapy (may produce irreversible
Folvite homocysteine levels. After anemias of nutritional in patients with failure secondary to fluid retention, neurologic damage).
being converted to origin, pregnancy, pernicioius anemia thromboembolism, thrombophlebitis, Resistance to treatment may occur
tetrahydrofolic acid in the infancy, or childhood without knowing fat embolism, cardiac arrhythmias if decreased hematopoiesis,
intestines, folic acid promotes whether they also alcoholism, antimetabolic drugs,
Actual dosage, synthesis of -A reduced form of folic have a Vit B12 Dermatologic: rash. deficiency of vitamin B6,
route, frequency several enzymes, including acid known as deficiency. B12, C, E is evident.
purine and thymidylates; citrovorum factor (or EENT: bitter or unpleasant taste in
metabolism of amino acids, leucovorin) is given to The danger is that your mouth During:
IM/IV/SQ/PO: including glycine and replenish endogenous folic acid - Monitor plasma vitamin levels and
ADULTS, methionine; and metabolism folic acid in patients on supplements can Endocrine: diarrhea, stomach Hbg, Hct, and reticulocyte counts
ELDERLY, of histidine, all of which are methotrexate (which mask the signs of upset ,seizures before and periodically during
CHILDREN 4 YRS essential for normal cell inhibits dihydrofolate Vit B 12 deficiency, therapy.
AND OLDER: 1–5 structure and growth. reductase). Citrovorin yet not prevent the GI: bloating, gas, stomach pain, -Because of infrequency of solitary
mg/day. (leucovorin) is better development of abdominal distention, nausea, vitamin deficiencies, combinations
absorbed compared to irreversible vomiting, nausea, loss of appetite; are commonly administered.
CHILDREN folic acid. neurological
YOUNGER THAN disease due to Vit Hematologic: increased blood levels, After:
4 YRS: Up to B12 deficiency. - Advise patient to consult
0.3 mg/day. Saunders Nursing drug Hypersensitivity: physician if irregular
INFANTS: 0.1 Handbook 2021 by Robert J. The Shilling test can Muscle weakness, steroid myopathy heartbeat,dyspnea, swelling of
mg/day. Kezoir and Keith Hodgson be used to test for and loss of muscle mass, hands and feet and hypotension
abnormalities in Vit osteoporosis, spontaneous fractures occurs.
PREGNANT/ B12 absorption.
LACTATING Other: Allergic reaction - Assess for therapeutic
WOMEN: 0.8 (bronchospasm, improvement: improved sense of
mg/day. erythema, fever, malaise, rash, well-being, relief from
pruritus) iron deficiency symptoms (fatigue,
shortness of breath, sore tongue,
headache,
pallor)..

Sacan , Chelsy Sky M.