Haematinics

Haematinics

1. haematinics Presented By : pankaj rana Nurse practioner SRHU

2. introduction Haematinics These are substances required in the formation of blood & are used for treatment of anaemias. Improving the condition of the blood. Also called haematinic & agent that stimulates the production of red blood cells or increase the amount of haemoglobin in the blood.

3. iron Iron is an essential mineral that is required for human life.Much of the iron in the body is found in red blood cells. Distribution of iron in body: Haemoglobin – 66% Iron stores as ferritin & haemosiderin – 25% Myoglobin – 3% Parenchymal iron – 6%

4. Daily requirement Adult male : 0.5-1 mg . Adult female : 1-2 mg. Infants : 60 /kg. Children : 25 /kg. Pregnancy (last 2 trimesters) : 3-5 mg.

5. Iron absorption- The major part of dietary iron is inorganic & in the ferric form. It needs to be reduced to the ferrous form before absorption. Its absorption occurs all over in the intestine.

6. Transport , utillization , storage & excretion- Iron in transported into erythropoietic & other cells . Iron dissociated from the complex at the acidic pH of the intracellular vesicles, the released iron is utilized for haemoglobin synthesis . Iron is stored in RE cells in liver, spleen bone marrow, also in hepatocytes & myocytes as ferritin . Iron is excreted through sweat ,very little in urine, desquamated skin, in some RBCs and in bile(all lost in faeces).

7. Preparation & dose- Oral Iron: 1.Ferrous Sulfate- Fersolate 200mg tab. 2.Ferrous gluconate- Ferronicum 300mg tab,400mg/15ml. 3.Ferrous fumarate- NORI-A 200mg tab. 4.Colloidal ferric hydroxide-Neoferum 200mg tab, 400mg/5ml liquid, 100mg/ml drops.

8. Parenteral Iron- IV ,IM. 1. Iron dextran:Imferon 2ml ampoule. 2. Iron sorbitol citric acid complex- Jectofer 1.5ml ampoule. Adverse effects- Epigastric pain Heartburn Nausea ,vomiting Metallic taste Constipation

9. Maturation factors Deficiency of vit B12 & folic acid , which are B group vitamins , result in megaloblastic anaemia characterized by the presence of large red cell precursors in bone marrow & their large & shortlived progeny in peripheral blood.vit B12 & folic acid are therefor called maturation factors.

10. Vitamin-b12 Cyanocobalamin & hydroxocobalamin are complex cobalt containing compounds present in the diet & referred to as vit B12. Daily requirement: 1-3 mg,pregnancy & lactation 3-5 mg.

11. Utilization of vitamin b12 Vit B12 is transported in blood in combination with a specific β globin transcobalamin 2 nd . Vit B12 is especially taken up by liver cell & stored about 2/3 to 4/5 of body’s content is present liver. It is excreted mainly in bile & urine. Doses: Cynocobalamin:35mg/5ml liq. ,100,500,1000mg inj.Redisol. Hydroxocobalamin:1000mg inj. Redisol-H. Methylcobalamin:0.5mg tab.Biocobal.

12. Folic acid It occurs as yellow crystals which are insoluble in water, but its sodium salt is freely water soluble. Daily requirement: In adult is <0.1mg but dietary allowance of 0.2mg/day is recommended. During pregnancy , lactation 0.8mg/day is considered appropriate .

13. utilization Folic acid is present in food as polyglutamate , the additional glutamate residues are split off primarily in the upper intestine before being absorbed. It is transported in blood mostly as methyl THFA which is partly bound to plasma protein. Folic acid stored in cell as polyglutamates. Liver takes up a large part & secretes methyl-THFA in bile which is mostly reabsorbed from intestine.

14. doses Folic acid : folvite , folitab 5mg tab. Dose : therapeutic 2 to 5 mg/day , prophylactic 0.5mg/day. Folinic acid: calcium leucovorin , 3mg/ml. inj. & fastovorin 50mg vial. Deficiency- Malabsorption Chronic alcoholism

15. Nursing responsibility B12 cyanocobalamin : Client with gastric,ileal resections, small bowel disease or malabsorption require parental use. Iron : Best to give on empty stomach but can give with food to decrease gastric upset. Assess haemoglobin levels & bowel movement as constipation is common. Folic acid : Contraindicated in uncorrected pernicious anemia.

16. Thank you