Pediatric Acute Anemia Medication

Updated: Aug 22, 2017
  • Author: Susumu Inoue, MD; Chief Editor: Robert J Arceci, MD, PhD  more...
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Medication

Medication Summary

Medications for specific forms of anemia may be indicated in addition to blood transfusion (eg, corticosteroids for autoimmune hemolytic anemia, iron therapy for iron deficiency anemia).

Recombinant erythropoietin has been available for the treatment of certain forms of anemia. Its use can allow for avoidance or minimization of the need for blood transfusion. Indications include anemias of chronic disease (eg, renal failure), chemotherapy, acquired immunodeficiency syndrome (AIDS) treatment, preparation for surgery with anticipated significant blood loss, prematurity, [16] and hyporegenerative anemia of erythroblastosis fetalis. It is important to note that erythropoietin is not indicated for the immediate correction of anemia. The correction of anemia with erythropoietin occurs after about 2-8 weeks.

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Blood Products

Class Summary

The goal of therapy in acute anemia is to restore the hemodynamics of the vascular system and replace lost red-blood cells. To achieve this, the practitioner may use blood transfusions. Major complications of acute anemia can be prevented by providing timely transfusion to restore hemoglobin to safe levels.

Packed red blood cells

Packed red blood cells (PRBCs) are used preferentially to whole blood since they limit volume, immune, and storage complications. PRBCs have 80% less plasma, are less immunogenic, and can be stored about 40 days (versus 35 days for whole blood). PRBCs are obtained after centrifugation of whole blood. Whole blood is not available in many blood banks. Currently, virtually all blood banks in the United States issue leukocyte-depleted (leukopoor) PRBCs. Leukopoor PRBCs prevent febrile transfusion reactions, leukocyte antigen–related allo-sensitization, and transmission of virus infections such as cytomegalovirus. Thus, they are a preferrable product compared with conventional PRBCs.

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Corticosteroids

Class Summary

Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body’s immune response to diverse stimuli. They may be used in autoimmune hemolytic anemia.

Prednisolone (Prelone, Millipred)

Prednisolone decreases autoimmune reactions, possibly by suppressing key components of the immune system.

Methylprednisolone (Depo Medrol, Medrol, Solu-Medrol)

This agent is used for initial management of acute hemolytic anemia. Intravenous methylprednisolone is recommended when the most rapid and reliable treatment of hemolytic anemia is required.

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Iron Salts

Class Summary

Iron salts are used for treating patients with iron deficiency anemia.

Ferrous Sulfate (Feosol, Fer-Iron, Slow FE)

Iron salts are used as building blocks for hemoglobin synthesis in treating anemia. They allow transportation of oxygen via hemoglobin and are necessary for oxidative processes of living tissue. Treatment should continue for about 2 months after correction of anemia and etiological cause in order to replenish body stores of iron. Ferrous sulfate is the most common and inexpensive form of iron utilized. Tablets contain 50-60 mg of iron salt. Other ferrous salts are used and may cause less intestinal discomfort because they contain smaller doses of iron (25-50 mg). Oral solutions of ferrous iron salts are available for use in pediatric populations.

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