This document discusses substances called haematinics that are important for blood formation and the treatment of anemias. It focuses on iron, vitamin B12, folic acid, and erythropoietin. Iron is essential for hemoglobin formation and is absorbed in the small intestine. Vitamin B12 and folic acid help in maturation of red blood cells and are required to prevent megaloblastic anemia. Erythropoietin is a hormone that stimulates red blood cell production in the bone marrow and helps treat anemia related to kidney failure.

1. BLOOD FORMING AGENTS
(Haematinics)
By:- Dr. Manish Pal Singh,
Associate Professor
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AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA

2. Haematinics:
❑ These are substances required in the formation of blood, and are used for
treatment of anaemias.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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3. Iron
❑ Iron has for long been considered important for the body- ‘Lauha bhasma’
(Calcined iron)’ has been used in ancient Indian medicine.
❑ In 1713 iron was shown to be present in blood.
❑ General Facts:-
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ARTONI, AGRA, UP, INDIA
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4. AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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•Hb (Haemoglobin) is a protoporphyrin;
each molecules having 4 iron containing
haeme residues.
•It has 0.33% iron.
•To raise the Hb level of blood by 1 g/dl—
about 200 mg of iron is needed. Iron is
stored only in ferric form, in combination
with a large protein apoferritin.

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ARTONI, AGRA, UP, INDIA
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Absorption of IRON
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ARTONI, AGRA, UP, INDIA
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FACTORS FACILITATING IRON ABSORPTION:-

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Factors impending iron absorption

8. ✓ Iron is transported inside mucosal cell by DMT1 & across basolateral
membrane BY FP1 transporter protein .
✓ Iron released into plasma binds to transferrin & transported to different cells.
Indications:-
▪ Dietary Iron deficiency
▪ Pregnancy
▪ Premature babies
▪ Malabsorption
▪ Haemodialysis
▪ Anaemia
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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9. ACUTE IRON POISONING:
❑ It occurs mostly in infants and children: 10–20 iron tablets or equivalent of the liquid
preparation (> 60 mg/kg iron) may cause serious toxicity in them.
❑ Manifestations-
❑ vomiting, abdominal pain, haematemsis, diarrhoea, lethargy, cyanosis etc.
❑ Treatment-
❑ Chelating drug (Desferrioxamine)- i.m./ 50mg/Kg/repeated 4-12 hr as required.
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ARTONI, AGRA, UP, INDIA
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Source*- https%3A%2F%2Fwww.indiamart.com%2Fproddetail%2Fdeferoxamine-desferal-injection

10. Maturation factors (Vitamin B12 &Folic Acid)
❑ Deficiency of vit.B12 & folic acid- results in ‘Megaloblastic anaemia’.
❑ Vit. B12 (Cyanocobalamin) is present in red crystals synthesized in nature only by
microorganisms; plants and animals acquire it from them.
❑ It being necessary for DNA synthesis and consequently for cell proliferation.
❑ Dietary sources Liver, kidney, sea fish, egg yolk, meat, cheese, legumes, etc.
❑ Daily requirement 1–3 μg, pregnancy and lactation 3–5 μg.
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ARTONI, AGRA, UP, INDIA
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Source*- https%3A%2F%2Fwww.amazon.in%2FNature-Made-Vitamin-B-12-

11. ➢ Vitamin B12 is a family of related compounds containing a cobalt atom
(cobalamins).
➢ The two dietary forms of vitamin B12 are available and they are known as
methylcobalamin (methyl-B12) and 5- deoxyadenosylcobalamin (coenzyme-
B12).
➢ Vitamin B12 is important in the normal functioning of the nervous system due to
its role in the synthesis of myelin and in the maturation of developing red blood
cells in the bone marrow.
➢ Synthetic forms of vitamin B12 are known as hydroxy-cobalamin and
cyanocobalamin (not occur naturally in foods).
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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12. Folic Acid (Vitamin B9)
➢ It occurs as yellow crystals which are insoluble in water, but its sodium salts
is freely water soluble.
➢ Chemically it is Pteroyl glutamic acid (PGA) consisting of pteridine +
paraaminobenzoic acid (PABA) + glutamic acid.
➢ Folic acid is a precursor needed to make, repair, and methylate DNA; a
cofactor in cell division and growth, such as in infancy and pregnancy.
➢ Folate is itself inactive. After absorption it is converted into the active
coenzyme, tetrahydrofolic acid, essential for amino acid and DNA
biosynthesis and cell division.
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Source & Formulations
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14. Indications-
▪ Treat magaloblastic anemia due to folate deficiency
▪ Pregnant women
▪ Premature infants
▪ Patients with hemolytic anemia
▪ Methotrexate toxicity
▪ Citrovorum factor rescue
▪ Enhance anticancer efficacy of 5-fluorouracil
▪ With anticonvulsant drugs
Sources- yeast , liver , green vegetables, fruits , nuts and cereals.
Daily requirements- Adult: 50 mcg / day; Pregnant women : 100-200 mcg / day;
Lactating women : 100-200 mcg / day
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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15. Erythropoietin
➢ Is a glycoprotein, normally made by the kidneys, that regulates red blood
cell proliferation and differentiation in bone marrow.
➢ Stimulates proliferation of colony forming cells.
➢ Induces haemoglobin formation & erythroblast maturation.
➢ Releases reticulocytes in the circulation.
➢ The recombinant human erythropoietin (Epoetin α, β) is administered 25–
100 U/kg by i.v. or s.c. injection 3 times a week.
➢ Indications- Chronic renal failure; anaemia
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ARTONI, AGRA, UP, INDIA
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Source*- https%3A%2F%2Fin.all.biz%2Ferythropoietin-g264419&psig