Haematinics

Introduction to Haematinics
Iron Cynacobalamine, Folic acid, Plasma expanders
Presented by
R. Rekha
Department of Pharmacology

1. 1 A seminar as a part of curricular requirement For 1 year M. Pharm. 1 semester 3-6-2021 Presented by R. Rekha, (20L81S111) M. Pharmacy Department of pharmacology Under the guidance of Mr. A. Sudheer Kumar.,M. Pharm, Ph.D . Associate Professor Dept. Of Pharmacology Haematinics

2. 2 Introduction of Haematinics Iron Cynacobalamine Folic acid Plasma expanders References Contents

3. 3 These are the agent required in the formation of blood & used for treatment of anemia's Etiology: Anemia occurs when, A. Blood loss (acute or chronic) B. Impaired red formation due to; a)Deficiency of iron,vit.B12. folic acid. b)Bone marrow depression C. Increased destruction of RBCs. HAEMATINICS

4. 4 1. Iron & it’s compound: eg:-ferrous succinate, ferrous sulfate, ferrous gluconate etc. 2. Maturation factor:- eg:-cynacobalamine, Hydroxy cynocobalamine 3. Miscellaneous:- eg:-copper, cobalt Riboflavin. Classification :-

5. 5 According to Greek thought MARS is the god of strength & IRON is dedicated to it . Source of iron :- Rich:- Liver, egg yolk, dry bean, dry fruit. Medium:- Meat, chicken, fish, banana, apple. Poor:- Milk & it’s product Daily requirement:- Adult male :- 0.5-1mg(13µg/kg). Adult female:-1-2mg(21µg/kg) Infant :-60µg/kg. Children :-25µg/kg Pregnancy :-3-5mg(80µg/kg). IRON

6. 6 Iron Absorption

7. 7 As such, on entering plasma it is immediately converted to the ferric form and complexed with a glycoprotein transferrin (Tf). Iron is transported into erythropoietic and other cells through attachment of transferrin to specific membrane bound transferrin receptors(T f Rs) The complex is engulfed by receptor mediated endocytosis. Iron dissociates from the complex at the acidic pH of the intracellular vesicles.  the released iron is utilized for haemoglobin synthesis or other purposes Tf and T f R are returned to the cell surface to carry fresh loads. Transport,utilization,storage & excretion:

8. 8 1. Iron deficiency anaemia. 2. Megaloblastic anaemia. 3. As an astringent :-Ferric chloride is used in throat paint. Adverse effects :- 1.Epigastric pain. 2. heartburn. 3. nausea, vomiting 4. staining of teeth 5. metallic taste. 6. Constipation. Therapeutic uses :-

9. 9 VITAMIN-B12 (Cyanocobalamine) 1. Vitamin B12 occurs as water soluble, thermostable red crystals. 2.It is synthesized in nature only by microorganisms; plants and animals acquire it from them. Dietary sources :-Liver, kidney, sea fish, egg yolk, meat, cheese. Daily requirement : 1–3 μ g, pregnancy and lactation 3–5 μ g. Cynacobalamine

10. 10 Essential for normal erythropoieses maintainance of normal myelin sheath Vitamin B12 is essential for the conversion of hom o- cysteine to methionine. Now it appears that interference with the reaction: Vitamin B12 is essential for cell growth and multiplication. Purine and pyrimidine synthesis . Metabolic functions:-

11. 11 Intrinsic factor secreted by stomach forms a complex with B12 attaches to specific receptors present on intestinal mucosal cells and is absorbed by active carrier mediated transport. Vitamin B12 is transported in blood in combination with a specific β globulin transcobalamine II (TCII). Vitamin B12 is especially taken up by liver cells and stored about 2/3 to 4/5 of body’s content (2–8 mg) is present in liver.  Vitamin B12 is not degraded in the body. It is excreted mainly in bile (3–7 μg /day); all but 0.5–1 μg of this is reabsorbed— considerable entero -hepatic circulation occurs. pharmacokinetics:

12. 12 Manifestations of vitamin b12 : Glossits Atropy of tongue&vagina Neurological: sub acute comibned degenaration of posterior harm leads to ataxia Paraesthesia Peripheral neuropathy Loss of memory,halogenation

13. 13 Therapeutic use :- Pernicious anaemia. Malabsorption syndrome Nutritional deficiency. Neurological condition. Psychitric disorder Adevrse drug reaction :- Allergic reactions have occurred by injection

14. 14  ACID Folic acid( Pteroyl glutamic acid) is a member of the B complex group of vitamin Dietary sources :- Liver, green leafy vegetables (spinach), egg, meat, milk. Daily requirement :- 0.2 mg/day FOLIC ACID

15. 15 Folic acid is present in food as poly-glutamates The additional glutamate residues are split off primarily in the upper intestine before being absorbed. Small, physiological amounts of folate are absorbed by specific carrier-mediated active transport in the intestinal mucosa Folic acid is rapidly extracted by tissues and stored in cells as polyglutamate. Liver takes up a large part and secretes methyl-THFA in bile & again reabsorbed by enterohepatic cycle 50-90% of adose may be excreated in urine Absorption,transport & utilization

16. 16 1. Conversion of homocysteine to methionine: 2. Generation of thymidylate, an essential constituent of DNA: 3. Conversion of serine to glycine. 4. Purine synthesis. 5. Histidine metabolism. Metabolic functions of folic acid

17. 17 Deficiency & menifestation :- 1. Megaloblastic anaemia. 2. Nutritional deficiency. 3. Malabsorption. 4. Epithelial damage. 5. Weight loss. Therapeutic use :- 1. Improve absorption. 3. Protect epithelial cell. 4. Growth factor. Adverse effects : Hypersensitivity reaction by injection.

18. 18 PLASMA EXPANDERS   Ideal properties of a plasma expander are : 1. Should exert oncotic pressure comparable to plasma. 2. Should remain in circulation and not leak out in tissues. 3. Should be pharmacodynamically inert. 4. Should not be pyrogenic or antigenic. 5. Should be stable, easily sterilizable. Dextran It is a polysaccharide obtained from sugar beat .

19. 19 The more commonly used preparation is dextran- 70. It expands plasma volume for nearly 24 hours. it is slowly excreted by glomerular filtration as well as oxidized in the body over weeks. Some amount is deposited in RE cells Dextran has nearly all the properties of an ideal plasma expander. Dextran-40 It acts more rapidly than dextran-70. It reduces blood viscosity. Microcirculation may improve. Dextran-70:

20. 20 1. Plasma loss. 2. Burn 3. Hypovolemic & endotoxin shock. 4. Sever trauma & extensive tissue damage 5. Whole blood loss. Contraindications 1. severe anaemia. 2. cardiac failure. 3. Pulmonary edema. USE OF PLASMA EXPANDERS :-

21. 21 1 .Agstaff, Adam, Claeson Marian. 2004. The Millennium Development Goals for Health-Rising to the Challenges. World Bank. Washington, Tripati, Goodman & Gillman.   2004;6;14.     2. Global Governance Initiative Annual Report 2005, world economic forum          3. Seshadri S. Nutritional anaemia in south Asia. In Malnutrition in South Asia. A Regional Profile. Ed. Gillespie S. UNICEF Regional Office. Reference :

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