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.