Management and Treatment of SCD is currently evolving. Common measures upon taken diagnosis are as follows: Anaglgesic-drug therapy must begin promptly and fluid must be replaced liberally, preferably orally but also intravenously if needed. Acute pain episodes must be treated by administering morphine, meperidine or hydromorphone parenterally in full therapeutic doses to relieve pain. For breakthrough pains, additional smaller doses can be given.
Adjunctive drugs can also be used such as hydroxyzine, diphenhydramine, promethazine, or nonsteroidal antiinflammatory drugs. For chronic pains, fentanyl patches can be given for moderate to severe pain while acetaminophen with codeine can be administered for patients experiencing mild to moderate pain (Steinberg1023). Currently, the best option for treating sickle cell anemia is through the use of hydroxyurea. This drug is antineoplastic that increases HbF concentration in patients.
This HbF is considred a potent inhibitor of deoxyhemoglobin S polymerization. Its mechanism in accomplishing this is however unclear but its admnistration results to considerable relief in inflicted patients. It is well tolerated and has minimal side effects (Ingram 7). Blood transfusion is also useful but it is not commonly administered to usual cases of anemia. This is often given to children with urgent need for blood replacement when blood is sequestered in an abnormal sized spleen or when transient apalstic crisis occurs due to parvovirus B19 infection.
Transfusion is also necessary in cases of hypoxia accompanied by acute chest syndrome (Steinberg 1024). Bone marrow transplantations are also done and recepients responded positively to the treatment. However, whether this procedure can reverse established organ damage is unknown, but reports suggest that there are considerable improvement in chronic lung, bone, and central nervous system disease (Steinberg 1028).
Works Cited
Steinberg, Martin H. “Management of Sickle Cell Disease. ” Drug Therapy 340 (1999): 1021- 1030. Christoph, Garrott W. , James Hofrichter, and William A. Eaton. “Understanding the Shape of Sickled Red Cells. ” Biophysical Journal 88 (2005): 1371–1376. Ingram, Vernon M. “Sickle-Cell Anemia Hemoglobin: The Molecular Biology of the First“Molecular Disease”—The Crucial Importance of Serendipity. ” Genetics 167: (2004): 1–7. Paul S. Frenette and George F. Atweh. “Sickle cell disease: old discoveries, new concepts, and future promise. ” The Journal of Clinical Investigation 117 (2007): 850-858.