This document discusses haematinics, which are substances that help form red blood cells and treat anemia. It focuses on iron, vitamin B12, and folic acid. Iron is essential for human life and is found mainly in red blood cells. Dietary iron needs to be converted to a form that can be absorbed in the intestines. It is stored in the liver, spleen, bone marrow and muscles. Oral iron supplements include ferrous sulfate and ferrous gluconate. Deficiencies in vitamin B12 and folic acid can cause megaloblastic anemia by preventing normal red blood cell maturation. Vitamin B12 is absorbed in the liver and intestines and is important for nerve

1. Presented By :
pankaj rana
Nurse practioner
SRHU

2. Haematinics
These are substances required in the
formation of blood & are used for
treatment of anaemias.
Improving the condition of the
blood.
Also called haematinic & agent that
stimulates the production of red
blood cells or increase the amount
of haemoglobin in the blood.

3.  Iron is an essential mineral that is
required for human life.Much of the iron
in the body is found in red blood cells.
Distribution of iron in body:
 Haemoglobin – 66%
 Iron stores as ferritin & haemosiderin –
25%
 Myoglobin – 3%
 Parenchymal iron – 6%

4.  Adult male : 0.5-1 mg .
 Adult female : 1-2 mg.
 Infants : 60 /kg.
 Children : 25 /kg.
 Pregnancy (last 2 trimesters) : 3-5 mg.

5. The major part of dietary iron is
inorganic & in the ferric form. It
needs to be reduced to the ferrous
form before absorption.
Its absorption occurs all over in the
intestine.

6.  Iron in transported into erythropoietic & other
cells .
 Iron dissociated from the complex at the acidic
pH of the intracellular vesicles, the released iron
is utilized for haemoglobin synthesis .
 Iron is stored in RE cells in liver, spleen bone
marrow, also in hepatocytes & myocytes as
ferritin .
 Iron is excreted through sweat ,very little in
urine, desquamated skin, in some RBCs and in
bile(all lost in faeces).

7. Oral Iron:
 1.Ferrous Sulfate- Fersolate 200mg tab.
 2.Ferrous gluconate- Ferronicum 300mg
tab,400mg/15ml.
 3.Ferrous fumarate- NORI-A 200mg tab.
 4.Colloidal ferric hydroxide-Neoferum 200mg
tab, 400mg/5ml liquid, 100mg/ml drops.

8. Parenteral Iron-
 IV ,IM.
 1. Iron dextran:Imferon 2ml ampoule.
 2. Iron sorbitol citric acid complex- Jectofer
1.5ml ampoule.
Adverse effects-
 Epigastric pain
 Heartburn
 Nausea ,vomiting
 Metallic taste
 Constipation

10.  Deficiency of vit B12 & folic acid , which are
B group vitamins , result in megaloblastic
anaemia characterized by the presence of
large red cell precursors in bone marrow &
their large & shortlived progeny in peripheral
blood.vit B12 & folic acid are therefor called
maturation factors.

11.  Cyanocobalamin & hydroxocobalamin are
complex cobalt containing compounds
present in the diet & referred to as vit
B12.
Daily requirement:
 1-3 mg,pregnancy & lactation 3-5 mg.

12.  Vit B12 is transported in blood in
combination with a specific β globin
transcobalamin 2nd.
 Vit B12 is especially taken up by liver cell &
stored about 2/3 to 4/5 of body’s content is
present liver.
 It is excreted mainly in bile & urine.
Doses:
 Cynocobalamin:35mg/5ml liq.
,100,500,1000mg inj.Redisol.
 Hydroxocobalamin:1000mg inj. Redisol-H.
 Methylcobalamin:0.5mg tab.Biocobal.

13.  It occurs as yellow crystals which are
insoluble in water, but its sodium salt is
freely water soluble.
Daily requirement:
 In adult is <0.1mg but dietary allowance
of 0.2mg/day is recommended.
 During pregnancy , lactation 0.8mg/day is
considered appropriate.

14.  Folic acid is present in food as polyglutamate
, the additional glutamate residues are split
off primarily in the upper intestine before
being absorbed.
 It is transported in blood mostly as methyl
THFA which is partly bound to plasma
protein.
 Folic acid stored in cell as polyglutamates.
 Liver takes up a large part & secretes
methyl-THFA in bile which is mostly
reabsorbed from intestine.

15.  Folic acid : folvite , folitab 5mg tab.
 Dose : therapeutic 2 to 5 mg/day ,
prophylactic 0.5mg/day.
 Folinic acid: calcium leucovorin , 3mg/ml.
inj. & fastovorin 50mg vial.
Deficiency-
 Malabsorption
 Chronic alcoholism

16. B12 cyanocobalamin:
 Client with gastric,ileal resections, small
bowel disease or malabsorption require
parental use.
Iron :
 Best to give on empty stomach but can give
with food to decrease gastric upset.
 Assess haemoglobin levels & bowel
movement as constipation is common.
Folic acid:
 Contraindicated in uncorrected pernicious
anemia.

17. Thank you