Anemia is a condition in which the blood has a reduced number of red blood cells (RBCs) or hemoglobin. This leads to poor oxygen-carrying capacity and results in fatigue, weakness, and reduced physical performance. Anemia is a common medical condition and may occur due to nutritional deficiencies, chronic diseases, bone marrow problems, or blood loss. Identifying the type and cause of anemia is essential for proper treatment.
1. Classification of Anemia
1. Based on Size (MCV)
- Microcytic anemia: Small RBCs (Iron deficiency anemia, Thalassemia)
- Normocytic anemia: Normal-sized RBCs (Acute blood loss, chronic disease)
- Macrocytic anemia: Large RBCs (Vitamin B12 or folate deficiency)
2. Based on Cause
- Iron deficiency anemia
- Megaloblastic anemia (B12 or folate deficiency)
- Hemolytic anemia (RBC destruction)
- Aplastic anemia (bone marrow failure)
- Anemia of chronic disease
2. Causes of Anemia
- Poor dietary intake of iron, folate, or vitamin B12
- Chronic blood loss (PUD, menstruation, GI bleed)
- Chronic kidney disease
- Genetic disorders (thalassemia, sickle cell disease)
- Medications causing bone marrow suppression
- Infections and autoimmune diseases
3. Symptoms of Anemia
- Fatigue and weakness
- Pale skin and conjunctiva
- Shortness of breath
- Rapid heartbeat
- Dizziness
- Cold hands and feet
- Brittle nails or hair loss (in iron deficiency)
- Tingling or numbness (in B12 deficiency)
4. Diagnosis of Anemia
- Complete Blood Count (CBC): Hemoglobin, hematocrit, RBC count, MCV
- Peripheral smear: RBC shape and size
- Serum iron, ferritin, TIBC: To assess iron status
- Vitamin B12 and folate levels
- Reticulocyte count: Bone marrow activity
- Kidney and thyroid function tests
- Bone marrow biopsy in suspected marrow failure
5. Types of Anemia and Treatment
1. Iron Deficiency Anemia
- Causes: Poor diet, blood loss, pregnancy
- Treatment: Oral iron supplements (ferrous sulfate), IV iron for severe cases
- Advice: Take iron with vitamin C for better absorption
2. Megaloblastic Anemia
- Causes: Vitamin B12 or folate deficiency
- Treatment: B12 injections, oral folic acid supplements
- Note: Never give folate alone in B12 deficiency (can worsen nerve damage)
3. Hemolytic Anemia
- Causes: Autoimmune disorders, infections, drugs
- Treatment: Steroids, immunosuppressants, treat underlying cause
- Severe cases: Splenectomy
4. Aplastic Anemia
- Cause: Bone marrow failure
- Treatment: Immunosuppressants, bone marrow transplant
5. Anemia of Chronic Disease
- Causes: CKD, infections, autoimmune disorders
- Treatment: Erythropoietin, treat underlying disease
6. Complications of Anemia
- Heart failure (due to increased cardiac workload)
- Poor growth and development in children
- Pregnancy complications
- Repeated infections
7. Dietary Recommendations
- Include iron-rich foods (spinach, meat, beans)
- Eat vitamin C–rich fruits for better iron absorption
- Consume B12-rich foods (eggs, fish, dairy)
- Add folate-rich foods (greens, lentils)
8. Role of the Pharmacist
- Identify symptoms of anemia and refer when needed
- Ensure proper use of iron, B12, and folate supplements
- Monitor side effects (constipation with iron)
- Educate on correct timing and food interactions
- Prevent drug-induced anemia through counseling
Detailed Notes:
For PDF style full-color notes, open the complete study material below: