Erythropoietin- Kokate

Erythropoietin (EPO) is a hormone produced primarily by the kidneys. It plays a key role in the production of red blood cells (RBCs), which carry oxygen from the lungs to the rest of the body.

1. ERYTHROPOIETIN Presentation by- Aditi Petwal B. Pharm V semester

2. INTRODUCTION Erythropoetin (EPO) is a sialoglycoprotein hormone produced by peritubular cells of the kidney- essential for normal erythropoiesis .

3. ERYTHROPOIESIS Erythropoiesis  (from Greek ' erythro ' meaning "red" and ' poiesis ' meaning "to make") is the process which produces red blood cells (erythrocytes), which is the development from  erythropoietic  stem cell to mature red blood cell.

4. ACTION Anaemia and hypoxia are sensed by kidney cells and induce rapid secretion of EPO Acts on erythoid series Stimulates proliferation of colony forming cells of erythroid series Induces haemoglobin formation & erythroblast maturation Release of reticulocytes in circulation

5. ACTION

6. PATHWAY EPO binds to specific receptors on the surface of target cells. The EPO receptor is a JAK-STAT binding receptor- alters phosphorylation of intracellular proteins and activates transcription factors-gene expression.

7. PATHWAY It induces erythropoiesis in dose dependent manner-no effect on RBC lifespan. Note- The recombinant human erythropoietin- Epoetin alpha, ß is administered by i.v . Or s.c . Injection ans has half life of plasma of about 6-10 hrs.

8. USES EPO therapy- patients with Hb≤8g/dl Epoetin 25-100 U/kg s.c or i.v . 3 times a week raises haematocrit and haemoglobin (Dose reduction by about 30% is possible when epoetin is given s.c . than i.v .) Improved-exercise capaciy and overall wellbeing of the patients For patients with low iron store and require concurrent i.v ./oral therapy.

9. USES Anaemia in AIDS patients treated with zidovudine . Cancer chemotherapy induced anaemia. Preoperative induced blood production for autologous transfusion during surgery.

10. ADVERSE EFFECTS Related to sudden increase in haematocrit , blood viscosity and peripheral vascular resistance which are- Increased clot formation in the AV shunt Hypertensive episodes Serious thromboembolic events Occasional seizures Flu-like symptoms-lasting 2-4hr

11. REFERENCES Essentials of MEDICAL PHARMACOLOGY, K. D. Tripathi , 7 th Edition , Jaypee brothers medical publishers, Haematinics and Erythropoietin, Page 611. Palazzuoli A, Ruocco G, Pellegrini M, De Gori C, Del Castillo G, Giordano N, Nuti R. The role of erythropoietin stimulating agents in anemic patients with heart failure: solved and unresolved questions.  Ther Clin Risk Manag . 2014;10:641-650

12. Thank You