Folic acid: Action Uses Dosage Administration Nursing Consideration by Nurses Note

 Folic acid

 Uses of Folic acid

Treatment of megaloblastic and macrocytic anaemias due to folate deficiency. Treatment of anaemias due to folate deficiency in pregnant women. Folate supplementation during periconceptual period decreases risk of neural tube defects.

Precautions For Folic acid

Contraindications: Hypersensitivity to folic acid. 

Cautions: Anemias (aplastic, normocytic, pernicious, refractory) when anaemia presents with vitamin B12 deficiency.

DHA HAAD MOH PROMETRIC AIIMS ESI EXAM PREPARATION NO:7

Action of Folic acid

Stimulates production of platelets, RBCs, and WBCs in folate deficiency anaemia.

Therapeutic Effect: Essential for nucleoprotein synthesis, maintenance of normal erythropoiesis.

Pharmacokinetics of Folic acid

PO form is almost completely absorbed from GI tract (upper duodenum). Protein binding: High. Metabolized in the liver. Excreted in urine. Removed by hemodialysis.

Lifespan considerations

Pregnancy/Lactation: Distributed in breast milk. Children/Elderly: No age-related precautions noted.

Interactions

DRUG: May decrease effects of PHENobarbital, phenytoin, primidone, and raltitrexed. 

HERBAL: Green tea may increase concentration. 

FOOD: None known. 

LAB VALUES: May decrease vitamin B12 concentration.

Availability (Rx) of Folic acid

Capsules: 0.8 mg, 5 mg, 20 mg. Injection Solution: 5 mg/mL. Tablets: 0.4 mg (OTC), 0.8 mg (OTC), 1 mg.

Administration/handling of Folic acid

PO

• May give without regard to food.

IV

May give 5 mg or less undiluted over at least 1 min, or dilute with 50 mL 0.9% NaCl or D5W and infuse over 30 min.

Nursing MCQ || Nursing Exam Practice || MOH HAAD DHA PROMETRIC EXAM QUESTIONS #shorts

Subscribe to Our YouTube Channel Click

Indications/routes/dosage of Folic acid

Anaemia

IM/IV/SQ/PO: ADULTS, ELDERLY, CHILDREN 4 YRS AND OLDER: 0.4 mg/day. CHILDREN YOUNGER THAN 4 YRS: Up to 0.3 mg/day.

INFANTS: 0.1 mg/day. PREGNANT/LACTATING WOMEN: 0.8 mg/day.

Prevention of Neural Tube Defects

PO: WOMEN OF CHILDBEARING AGE: 400–800 mcg/day. WOMEN AT HIGH RISK OR FAMILY HISTORY OF NEURAL TUBE DEFECTS: 4 mg/day

Side effects

None known.

Adverse effects/toxic reactions

Allergic hypersensitivity occurs rarely with parenteral form. Oral folic acid is nontoxic.

Nursing considerations of Folic acid

Baseline assessment

Pernicious anaemia should be ruled out with a Schilling test and vitamin B12 blood level before initiating therapy (may produce irreversible neurologic damage). Resistance to treatment may occur if decreased hematopoiesis, alcoholism, antimetabolic drugs, deficiency of vitamin B6, B12 C, and E is evident.

Intervention/evaluation

Assess for therapeutic improvement: an improved sense of well-being, relief from iron deficiency symptoms (fatigue, shortness of breath, sore tongue, headache, pallor).

Patient/family teaching

• Eat foods rich in folic acid, including fruits, vegetables, and organ meats.