Macrocytic Anemia

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Macrocytic Anemia Case Study .

Irving Olson, a 75 year old male comes to see you today with complaints of fatigue.  You order a CBC and determine that Irving has macrocytic anemia.  You order further testing and diagnose Irving with vitamin B12 deficiency.

Questions:

  1. What are non-pharmacologic treatment strategies for the management of vitamin B12 deficiency?
  2. What pharmacologic treatment is used first line for a patient with vitamin B12 deficiency (be sure to include, at a minimum, drug name, dose, route, frequency)? What other treatment options exist? Why did you choose your treatment option over other available options (if applicable)?
  3. When is it appropriate to use vitamin B12 (administered orally)?
  4. What is the mechanism of action of the pharmacologic agents discussed in #2? How does the mechanism of action correlate with the physiology/pathophysiology of vitamin B12 deficiency anemia?
  5. What are the most common adverse effects of the pharmacologic agents discussed in #2?
  6. What is the cost of the pharmacologic agents discussed in #2?
  7. Discuss pharmacokinetics and pharmacodynamics of the pharmacologic agent discussed in #2? (Be sure to include, at a minimum, onset, peak, duration, half-life, etc).