2. BLOOD COMPONENTS
PLASMA
Liquid part of blood
Contains proteins essential for immune response
&blood clotting
FORMED ELEMENTS OF THE BLOOD
LEUKOCYTES (WBCS): Part of the immune system
ERYTHROCYTES (RBCS): Carry oxygen to the tissues and
remove carbon dioxide
3. FACTORS ESSENTIAL FOR
ERYTHROPOESIS
ADEQUATE AMOUNTS OF IRON
Form hemoglobin –for oxygen
MINUTE AMOUNTS OF VIT.B12 & FOLIC ACID
ESSENTIAL AMINO ACID & CARBOHYDRATE
To complete the hemoglobin rings, cell
membrane, and basic structure
4. ANEMIA
• ↓ Concentration Of haemoglobin in blood
• Symptoms of fatigue, pallor, dizziness, exertional
dyspnea (∵of tissue hypoxia)
• Cardiovascular adaptations to chronic anemia—
tachycardia, increased cardiac output,
vasodilation
5. TYPES OF ANEMIA
IRON DEFICIENCY ANEMIA
• Deficiency of iron
• Hypochromic, microcytic anaemia (small red cells with
low Hb)
MEGALOBLASTIC ANEMIA
• Deficiency of folic acid /vitamin B12
• Macrocytic anaemia (large R.B.C,↓Number)
PERNICIOUS ANEMIA
No intrinsic factor :vitamin b12 not absorbed
6. IRON DEFICENCY ANEMIA
• Deficient synthesis of Hb Due to lack of iron
• HYPOCHROMIC MICROCYTIC ANEMIA
• In adults most common cause : blood
loss(menses,labour)
7. IRON ABSORPTION
• Animal foods iron is better absrbed
• Iron is absorbed from brush border of upper part of small
Intestine
FACTORS AFFECTING IRON ABSORPTION
• Only ferrous form absorbed (ferric converted to ferrous
form by acids)
• ↑ ABSORBTION: Acids, reducing agents (vit.C, succinate),
meat, Fe Deficiency
• ↓ABSORBTION :Alkalies, antacids, phosphorus, phytates,
tetracyclines
• surgeries (partial gastrectomy, infectious diseases,
malabsorption syndrome
8. IRON DISTRIBUTION
TRANSPORT
Bound to transferrin: -globulin
STORAGE
• Complexed with apoferritin
(AF) and stored as ferritin in
R.E.Cells, bone Marrow
Hepatocytes
• As heme-in Hb of RBC,
myglobin & cytoch. Oxidase
enzymes
9. IRON ELIMINATION
• Exfoliation of intestinal mucosal cells
• Trace amounts are excreted in bile, urine, and
sweat.
• Total loss of iron is 1 mg/day
11. IRON PREPARATIONS
PARENTERAL PREPARATIONS
• 20 – 40 mL Iron dextran deep I.M/I.V.
• Iron sorbitol citric acid complex
ADVERSE EFFECTS
• Pain, pigmentation skin, sterile abcess
• Fever, headache, Palpitation, chest pain,
Anaphyloid reaction, Metallic taste
12. MEGALOBLASTIC ANEMIA
• Deficient synthesis of Hb Due to
– Lack of Vit B12
– Folic acid
– Both
• Macrocytic anemia+ leukopenia or
thrombocytopenia or both
• Hypercellular bone Marrow With ↑
megaloblastic erythroid & other precursor cells.
13. VITAMIN B12
• Available as cyanocobalamin
hydroxycobalamin.
• Source: microbial synthesis
• Not synthesized By plants or animals
• Chief dietary source is microbially derived
Vitamin B12 in meat (liver), eggs, dairy
products and legumes.
14. VIT.B12:PHARMACOKINETICS
•Vit B12+intrinsic
Factor
(Stomach parietal cell R.
On distal ileum
Active absorption
Transport in blood:
transcobalamin II
Stored in liver
Trace amount lost
in urine & stool.
R:GASTRIC BINDING PROTEIN,
Cbl: COBALOMIN, IF;INTRINSIC FACTOR,TCII:TRANSCOBALOMIN II
15. VITAMIN B12 DEFICIENCY
SYMPTOMS OF DEFICIENCY
• Megaloblastic anemia
• Neurologic syndrome :paresthesias spasticity,
ataxia,neuritis
TREATMENT
• Vitamin B12:I.M Injection given life long
ADVERSE EFFECTS:
• Hypokalemia and hypersensitivity
16. FOLIC ACID (PTEROYLGLUTAMIC
ACID)
• Richest source is yeast, liver kidney and green
vegetables.
• Involved in DNA synthesis
SYMPTOMS OF DEFICIENCY
• Megaloblastic anemia
• Glossitis, diarrhea, weight Loss, debility
TREATMENT:Folic acid 1 mG/Day
OTHER USES: Prevention of fetal neural tube defects
17. APLASTIC &HEMOLYTIC ANEMIA
• APASTIC ANEMIA
– Due to drugs: total lack of all hemopoetic cells
– Stop the drug involved in aplastic anemia
• HEMOLYTIC ANEMIA
– Due to genetic problems
• Rx FOR BOTH ANEMIAS
– Blood transfusion
– Corticosteroids
– May use iron, Vitamin B12 & folic acid
