Rx Note

Introduction Anemia is defined for patient care as a reduction in one or more of the major red blood cell measurements obtained as part of the complete blood count. Hemoglobin concentration To convert to mmol/L, the hemoglobin in g/dL can be multiplied by 0.62. Hematocrit Also called packed cell volume. Is the percentage of blood cell volume occupied by red blood cells. Red blood cell count A low hemolobin concentration and/or low hematocrit are the parameters most widely used to diagnose anemia. WHO criteria for anemia in adults are Females - Hemoglobin <12 g/dL or hematocrit <36% Males - Hemoglobin <13 g/dL or hematocrit < 39% NOTE: Reticulocytes are immature red blood cells. Symptoms Most patients with mild or early-stage anemia are asymptomatic. If anemia becomes severe and/or prolonged, the lack of oxygen in the blood can lead to classic symptoms of fatigue, weakness, shortness of breath, exercise intolerance, headache, dizziness, anorexia and/or pallor . If sudden ...

Drug Safety Update Vitamin B12, also referred to as cobalamin, is a water-soluble vitamin that is naturally present in foods or animal origin such as meat, dairy and eggs. Vitamin B12 deficiency is defined as a reduced serum B12 level of ≤300 pg/mL (221 pmol/L). Vitamin B12 deficiency can be asymptomatic or associated with haematologic (such as megaloblastic anaemia), neurologic (such as peripheral neuropathy), and psychiatric disorders (such as impaired memory and irritability) that can usually be reversed by early diagnosis and treatment. Vitamin B12 deficiency is now regarded as a common adverse drug reaction and may affect up to 1 in 10 people who take metformin . Several oversea studies have shown that the occurrence of vitamin B12 deficiency is common among patients on metformin ( ranging from 4.3% to 30%) . The risk increases with a higher dose, longer treatment duration and in patients with risk factors for vitamin B12 deficiency. In a local study by Krishnan et al. (2020) ...