The Hematinic agents, Slides of Pharmacology

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Hematinics

Contents

⚫ Erythropoiesis

⚫ Causes of Anemia

⚫ Hematinic Agents

⚫ Iron

⚫ Iron Preparations

⚫ Folic Acid

⚫ Vitamin B

Anaemia

❑ Anaemia is characterised by a reduced haemoglobin content in the

blood. It may cause fatigue but, especially if it is chronic, is often

surprisingly asymptomatic. Heamoglobin level below 14-18 g/dL in

males and below 12-16 g/dl in females is considered as anaemia.

❑ There are different types of anaemias, most of which occur due to

blood loss, deficiency of nutrients, depression of the bone marrow or

increased destruction of red cells (haemolytic anaemias). Nutritional

deficiencies of iron, vitamin B or folic acid are common and

important factors that causes anaemia.

Cause of Anaemia based on Mechanism

1. Decreased production of RBC a) Aplastic anaemia (Bone marrow disorder) b) Chronic kidney disease (Decreased production of erythropoietin) c) Hypothyroidism (Decreased production of erythropoietin) d) Iron / Vit b9 and Vitamin B12 deficiency e) Chronic Inflammatory Disease (Decreases iron and breaks down RBC)
2. Blood loss (GI blood loss, trauma, accidents, heavy periods, etc.)
3. Increased RBC destruction a) Sickle cell anaemia b) Thalassemia c) Malaria d) Hyperactive spleen
4. Other causes a) Malabsorption of iron and vitamins b) Pregnancy c) Malignancy

Types of Anaemia based on Mean Corpuscular Volume

Hematinic Agents

❑ Hematinics are drugs used to stimulate the formation of red blood

cells. Example:

✔ Iron

✔ Folic Acid

✔ Vitamin B

❑ Used primarily in the treatment of anemia.

❑ Therapy of anemia must be tailored to the specific cause of

anemia. For e.g. iron is reserved solely for iron deficiency anemia

and Vitamin B12 for megaloblastic and pernicious anemia.

❑ Iron supplements, also known as iron salts and iron pills, are a number of iron formulations used to treat and prevent iron deficiency including iron deficiency anemia. ❑ Ferrous fumarate, ferrous gluconate, ferrous sulfate and polysaccharide-iron complex etc. are used orally in the prevention and treatment of iron deficiency.

Iron Preparations

Iron Preparations

1. Ferrous Fumarate: Usual Dose: 200 mg (equivalent to 60 mg of elemental iron), two or three times daily. Dose Range: 200mg-600mg daily Dosage Forms: Mostly available as tablets 2. Ferrous Gluconate:

Usual Dose: 300 mg (Equivalent to 35 mg of elemental iron) three times daily Dose Range: 300mg-900mg daily Dosage Forms: Mostly available as tablets and syrups