Anti anemial drugs

1. Treatment of anemia

2. Table of content
01 04
03
02
06
05
About the disease
Causes
Symptoms
Types
Classification of drugs
Iron
Drugs
Adverse effects
Precautions
Cyanocobalamin (vitamin B12)
Therapeutic uses
Adverse effect
Pharmacokinetics
Contraindication
Erythropoietin Therapy
Therapeutic uses
Adverse effects
Contraindication
Folic acid
Therapeutic uses
Mechanism of action
Pharmacokinetics

3. About Anemia
Anemia is a deficiency of red blood cells or
hemoglobin, which inhibits oxygen delivery to
muscles, organs, and other tissues.
01
Cause
Genetic factors
Excessive bleeding
Cancer causing anemia
Menstrual bleeding
Iron deficiency

4. Symptoms
• Light headed
• Fatigue
• Weakness
• Shortness of breath
• Dizziness

5. Types
• Anemia due to vitamin B12 deficiency
• Anemia due to folate (folic acid)
deficiency
• Anemia due to iron deficiency
• Hemolytic anemia
• Megaloblastic anemia
• Pernicious anemia

6. Classification of drugs
• Cyanocobalamin (B12)
• Folic acid
• Iron
• Erythropoietin

7. Iron
• Iron is stored in the intestinal mucosal cells, liver,
spleen, and bone marrow as ferritin (an iron–protein
complex) until needed by the body.
• Iron is delivered to the marrow for hemoglobin
production by a transport protein, namely transferrin.
• Iron deficiency results from acute or chronic blood loss,
from insufficient intake during periods of accelerated
growth in children, and in heavily menstruating or
pregnant women.
• Thus, iron deficiency results from a negative iron
balance due to depletion of iron stores and/or
inadequate intake.

8. Drugs
for
iron
Iron
formulation
Brand name Iron
percentage
Pharmacokinetics
Ferrous
gluconate
Fergon 12 Orally absorbed
iron dextran dexferrum 50 IV absorbed
Ferrous
sulfate
Feosol 20 Orally absorbed
Ferrous
fumarate
Ferretts,
Ferrimin
33 Orally absorbed
Polysaccharide
-iron complex
Niferex 100 Orally absorbed

9. Adverse effect
GI Track
disturbance
Dark stool
Anaphylactoid
reactions
Fatal
hypersensitivity
IRON
• Oral parenteral

10. Precautions:
• Children
• Pregnancy and breast-feeding
• Diabetes
• Hemodialysis

11. Cyanocobalamin (vitamin B12)
Cyanocobalamin is a man-made form of vitamin B12
used to prevent and treat low blood levels of this
vitamin. Most people get enough vitamin B12 from
their diet. Vitamin B12 is important to maintain the
health of your metabolism, blood cells, and nerves.
• Deficiencies of vitamin B12 can result from
• low dietary levels
• poor absorption of the vitamin
Therapeutic uses:
• Maintaining nervous system
• Treatment of anemia for metablosim of folic acid

12. Pharmacokinetics
• The vitamin may be administered
orally, intramuscularly, or deep
subcutaneously.
• Adverse effects
• In case of severe anemia it causes
hypokalemia
• Muscle cramps
• Weakness
• Irregular heartbeat

13. Contraindication:
• sensitivity to vitamin B12.
• Leber's disease, which affects the optic
nerve.
• kidney problems.
• hypokalemia, or low potassium levels.
• deficiencies in other nutrients,
particularly folic acid and iron

14. Erythropoietin
Therapy:
• Recombinant human
EPO is available
(epoetin alfa, and
darbepoetin)
• It is essential to
increase normal red
blood cell production
and treat anemia.
• EPO is given i.v or s.c.
injection once weekly
to target Hb level
between 10-12 gm/dl.

15. Therapeutic uses:
• In treatment of anemia due to:
• Anemia associated with chronic
renal failure.
• Bone marrow suppression e.g. cancer
chemotherapy.
• Multiple myeloma and cancer of
bone marrow.

16. Adverse effects;
• Hypertensive episodes
• Flu like symptoms
• Headache and seizures.
• Serious thromboembolic events
• Irritation at injection site

17. Contraindications:
• Uncontrolled hypertension.
• Known hypersensitivity to albumin
• Known hypersensitivity to mammalian cell-
derived products.
• thromboembolism

18. Folic acid:
• It is a B-complex vitamin needed by
the body to manufacture red blood
cells.
• stimulates the production of red blood
cells, white blood cells, and platelets
• Absorbed folic acid from diet requires
reduction by dihydrofolate reductase
to the active form tetrahydrofolate.

19. Mechanism of action:
• An exogenous source of folate is required
for nucleoprotein synthesis and the
maintenance of normal erythropoiesis.
• Folic acid, whether given by mouth or
parenterally, stimulates the production of
red blood cells, white blood cells, and
platelets in persons suffering from
certain megaloblastic anemias.

20. Pharmacokinetics:
• Follic acid is well absorbed in the
jejunum.
• If ingested in excessive amounts then
they are excreted in urine and feces.
• Oral folic acid is administration is
nontoxic
• Rare hypersensitivity to parenteral
injections have been reported.

21. Dietary sources:
• liver, green leafy vegetables, egg,
meat, milk, yeast.
Daily requirement:
• Dietary allowance of 0.2mg/day is
recommended.
• During pregnancy, lactation 0.8mg/day
is considered appropriate.

22. Therapeutic use:
• Treatment of Megaloblastic anemia.
• In pregnancy: to prevent fetal nural
tube defect(spina bifida)
• Side effects:
• Allergic sensitization
• Flushing
• Irritability
• Difficulty in sleeping
• Malaise may occur

23. Contraindications:
• Prior to therapy with folate, in
megaloblastic anemia, vitamin B12
deficiency must be excluded, as
neuropathy may be precipitated.

24. Thank you for your attention
Your questions are always welcome