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

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K.R.Palli Cross, Chiyyedu, Anantapuramu, A. P- 515721 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. RIPER
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SIRO- DSIR
Raghavendra Institute of Pharmaceutical Education and Research - Autonomous
K.R.Palli Cross, Chiyyedu, Anantapuramu, A. P- 515721 2
Introduction of Haematinics
Iron
Cynacobalamine
Folic acid
Plasma expanders
References
Contents

3. RIPER
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K.R.Palli Cross, Chiyyedu, Anantapuramu, A. P- 515721 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

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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:-

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• 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

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Iron Absorption

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 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:

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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:-

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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 μg, pregnancy and lactation 3–5 μg.
Cynacobalamine

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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:-

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 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:

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• 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

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

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 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

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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

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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

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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.

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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 .

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• 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:

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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:-

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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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