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Hydroxocobalamin 1mg/mlLynne Powell RN, MSc. IP. PgCEd.
Aims & objectives
To explore the facts about vitamin B12
Identify the sources of vitamin B12
Look at the complications caused by deficiency
Discuss the treatment of deficiency
Consider the administration of cobalamin
FACTSVitamin B12 (cobalamin)
Is a water-soluable vitamin
Commonly known as the red vitamin
Can not be produced by the body
Found in food
Stored in the liver
Stores can last 3-5 years in the liver
Absorbed form the small bowel in the presence of intrinsic factor
What does it do?Form and regenerate red blood cells
Promotes growth and appetite in children
Increase energy
Maintains a healthy nervous system
Improves memory, concentration and balance
Utilses fat, protein and carbohydrate
Deficiency of B12
Originally low levels were only detected when the patient became clinically ill
Prior to the discovery of treatment, it was a fatal condition
Modern tests are now used to diagnose the disease before it becomes clinically apparent
Without enough B12 your body can’t make enough red blood cells
Pernicious anaemia
Type of megaloblastic anaemia
Loss of gastric parietal cells (GPC)
GPC secrete intrinsic factor
Intrinsic factor = a protein essential for absorption of B12
B12 is surrounded by a protein that is separated in the presence of hydrochloric acid, b12 is then able to bind with IF
Treatment regimes for pernicious anaemia (BNF June 2014) Hydroxocobalamin 1mg pernicious anaemia without
neurological involvement – 1mg 3 times a week for 2 weeks then 1mg every 3 months
Hydroxocobalamin 1mg pernicious anaemia with neurological involvement – 1mg on alternate days until no further improvement, then 1mg every 2 months months
Remember its not your role to prescribe, this is for your information
only
Is the regime documented in the notes?
Administration equipment
• 2ml syringe
• Selection of green and blue hypodermic needles
• ampule of hydroxocobalamin
• Cottonwool
• Tape or plaster (not always needed)
Name of drug ; hydroxocobalamin; cobalin H
Pre administration check
Colour of contents
Batch number
NEXT
1. Change the hypodermic needle
2. Expel excess air, remove the needle cover
3. Inject into the deltoid muscle (slowly)
4. Remove the needle and dispose of the equipment as a whole into a yellow topped sharps box. Do NOT re-sheath a needle
5. Check the injection site; dress only if needed
Documentation
Patient identification; e.g. name, DOB, address, etc.
Has the treatment regime been documented in the notes???
The name of the drug and dose; e.g. hydroxocobalamin 1mg/ml
The batch number; e.g. BN 72315
The expiratory date; e.g. Exp. 03/2015
The site of injection; e.g. right arm
Date of next injection; give this information to the patient.