Heamatinics by nihal
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HAEMATINICS &
RECENT DISCOVERED DRUG by
Amritanshu Nihal Department of pharmacy ITM University,Gwalior
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HaematinicsHaematinics are substances which required in formation of blood, & are used for treatment of Anemia. Anaemia is characterized by low haemoglobin count. WHO defines anaemia as Haemoglobin levels less than 13 g/dl in males & less than 12 g/dl in females. In adults, the lower extreme of the normal haemoglobin is taken as 14.0 -16 g/dl for males and 12 -14 g/dl for females.
Include : iron, vitamin B12
folic acid
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Transportation & storage of iron
Essentials of Medical pharmacology by KD Tripathi – 7th Edition, JAYPEE, 2013
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Iron – Transport & storage Diet – 10 to 20 mg – absorbed from all over the Intestine (more
from upper part) 2 forms – haeme and Inorganic
Haeme – minor form of dietary Iron but absorbed better without any transporter
Inorganic – in ferric form but absorbs lesser – converted to ferrous form in Intestine for absorption – needs transporter
Divalent metal transporter (DMT1) and Ferroportin (FP)
Factors increasing absorption – acid, reducing substances – ascorbic acid, amino acid etc. and meat
Factors impending absorption – alkali (antacids), Phosphates, phytates, tetracycline and presence of other food
Mucosal block: from mucosal cell – transported to plasma or remains stored in mucosal cell by forming ferritin - Ferritin curtain Balance between those two – detremines how much Iron to enter
body - by haematopoietic transcription factor
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Iron:-*An essential body constituent,*total body iron in an adult is 2.5-5g(3.5-avg.)*if<50mg/kg,distributed in to*heamoglobin:- 66%*stored as ferritin &heamosiderin;-25%*myoglobin:- 3%*parenchymal ron(enzume etc.):- 6%
PREPARATION AND DOSEOral preparations: 1. Ferrous sulfate: is cheapest (FERLOSATE-200mg.tab.) 2. Ferrous gluconate:(12% iron) FERRONICUM- 300MG. TAB.3. Ferrous fumarate:(33% iron) NORI-A 200mg.tab.
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Parenteral preparations:Iron therapy by injecting is indicated only when
1.Oral is not tolerated 2.Failure to absorb oral iron 3.In presence of severe chronic bleeing
1.Iron dextran:50mg. (Elemental iron/ml.)
IMFERON inj.-100mg/2ml-IM,IV
2. Iron sorbitol citric acid complex 75mg/day
FERIMAX-amp.(drug+folic acid-
0.75mg+hydrocobalamin-75ug
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Adverse effects of oral ironConstipation due to astringent effect, Epigastric pain,
Heartburn, Nausea&Vomiting, bloating, Teeth staining, Metallic taste, Start with low dose then increase the dose higher.
Prevention: Takes immediately after or with meals
Staining of teeth ( with liquid formulations)Blackening of stools
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Adverse effects of parenteral iron : Pain at site of injection (I.M.) Pigmentation of skin, (especially in old age patient) Fever, headache, joint pain, chest pain Hypersensitivity reaction
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Therapeutic uses of iron1. Treatment of iron deficiency anaemia 2. Prophylaxis of iron deficiency anaemia
Pregnancy, lactation Infants and growing children Professional blood donors
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Cynocobalamin and Hydroxocobalamin are complex cobalt containing compound present in diet and reffered to as VIT. B12
SOURCE: seafish, egg yolk,meat cheese , only vegetable source is PULSES
REQUIREMENT:- 1-3ug,pregnancy and lactation 3-5ug
Preparations:Cyanocobalamin
(NEUROBION FORT INJ.-1000ug/3m.)
Hydroxocobalamin (BICISULE cap.)
Methylcobalamin:-(methyl B12)This preparation of vitB12 in a dose of 1.5mg/dayBIOCOBAL,DIACOBAL,METHYL COBAL0.5mg.tab.
Vitamin B12
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Uses of vitamin B12
1.Treatment and prophylaxis of vitamin B12
deficiency (megaloblastic anemia)
2. Vit B12 injection in pernicious anemia
(condition where Vit B12 is not absorbed from the stomach)
*Mega dose of vit.B12 has also used in neuropathies,& psychiatric disease,
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FOLIC ACIDYellow crystal & insoluble in water but it’s sodium salt freely
water soluble.Chemically it is PGA(pteroyl glutamic acid) consisting of
petridine+PABA+glutamic acidSOURCE:-green leaf, spinach,egg,meat,milk etcREQUIREMENT:-in adult<0.1mg/day,but during pregnancy or
any high metabolic activity0.8mg/day.
Preparations Folic acid:-(falvite,folitab 5mg.tab.) Folinic acid :RECOVORIN 15mg.tab,50mg.vial for
inj.
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Therapeutic uses - Megaloblastic anemias due to folic acid deficiency - As supplement during pregnancy - To prevent deficiency:
Antiepileptic therapy Methotrexate toxicity:-folic acid is an active coenzyme
form which does not need to be reduced by DHFRase inhibitor;its toxicity is not counteracted by folic acid, but anta gonised bu folinic acid.
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Current discovered Haematinics POLYHERBAL FORMULATION IN hgcl2 INDUCED
ANAEMIA IN LABORATORY ANIMALS shows Haematinics activity
. *Composition of Haema Tablet: Amalaki 60 mg, Haritaki 60
mg, Mandur bhasma 40 mg, Mustak 60 mg, Shunthi 60 mg, Vidang 60 mg, Bibhitaki 60 mg, Indryava 60 mg,Suvarna makshik bhasma 40
aqueous extract of Hibiscus cannabinus leaves have haematinic properties.
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