Haematinics are substances required in the formation of the blood, and are used for treatment of anaemias.

1. Presented By – Gyanendra Kumar Prajapati
1st year M.Pharm
Department of Pharmacology
KLE University’s College of
Pharmacy, Bengaluru
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2. Haematinics :
Haematinics are substances required in the formation of the
blood, and are used for treatment of anaemias.
General term for those nutrients, including iron, folic acid,
and vitamin B12, required for the formation and
development of blood cells in bone marrow (the process
of haematopoiesis ), deficiency of which may result in
anaemia .
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DEFINITION

3. These are substances required in blood formation are used
as adjuvant in treatment of anemia.
Main Haematinics are:
• Iron
• vitamin B12
• Folic acid
• Growth factors
• Substances required for formation of blood
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4. Hematopoiesis
 The production of circulating erythrocytes, leukocytes
and platelets from undifferentiated stem cells, is called
hematopoiesis.
 It requires:
 Iron –for Hb formation
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5. Anemia:
 Decreased capacity of Red Blood Cells to carry
oxygen to tissues.
Causes:
 Blood loss,
 Impaired RBC formation- Iron, Vit B12, folic acid
deficiency,
 Bone marrow depression,
 Erythropoietin deficiency,
 Haemolytic anaemia.
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7. Transport of Iron
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8.  Transport:
Transported in the plasma bound to transferrin , a -
globulin that specifically binds two molecules of
ferrous iron .
 The transferrin -iron complex enters maturing
erythroid cells by a specific receptor mechanism.
 Transferrin receptors internalize the transferrin-iron
complex through the process of receptor-mediated
endocytosis .
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9.  Increased erythropoiesis is associated with an increase
in the number of transferrin receptors on developing
erythroid cells.
 Iron store depletion and iron deficiency anemia are
associated with an increased concentration of serum
transferrin.
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10. ELIMINATION
 Small amounts are lost in the feces by exfoliation of
intestinal mucosal cells, and trace amounts are
excreted in bile, urine, and sweat.
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11.  Iron deficiency occurs due to:
 Malnutrition
 Loss
 Congenital atransferrinemia (inability to release iron
from transferrin).
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12.  Iron is the integral component of haeme. In our body:
 66-67% of iron is present in hemoglobin.
 3% occurs in myoglobin .
 1% in enzymes -cytochrome, catalase, peroxidase .
 25% is stored in form of ferritin and hemosiderin .
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13.  Heme iron (present in meat).
 Inorganic iron.
 Free inorganic iron is very toxic, thus there are
regulatory mechanisms for:
 a.Absorption
 b. Transport
 c. Storage of iron
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14.  Acid
 Acid enhances dissolution and reduction of ferric iron.
 Reducing Substances
 Ascorbic acid reduces ferric iron and forms absorbable
complexes.
 Meat
 Meat also facilitates iron absorption by increasing HCl
secretion
 Pregnancy/ Menstruation
 Due to increased iron requirement.
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15.  1) Pregnancy- from 4th month to lactation.
 2) Menstruation
 3) Infancy and childhood
 4) Premature babies and babies weaned late
 5) Professional blood donors
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16. A vitamin important for the normal formation of red
blood cells and the health of the nerve tissues.
Undetected and untreated vitamin B12 deficiency can
lead to anemia and permanent nerve and brain
damage.
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17. 1.Decrease intake in diet
2. Increase demand during growing peroid pregnancy
3. Fish tape worm infestation
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18. 1.Megaloblastic anemia
2.Crohn's disease
3.Celiac disease
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19. Vitamin B12 for parenteral injection is available as
cyanocobalamin or hydroxocobalamin
 Administered in initial therapy should consist of
100–1000 mg of vitamin B12.
 Maintenance therapy consists of 100–1000 mg
intramuscularly once a month for life neurologic
abnormalities are present, maintenance therapy
injections should be given every 1–2 weeks for 6
months before switching to monthly injections.
 Oral doses of 1000 mg of vitamin B12 daily are
usually sufficient to treat patients with pernicious
anemia.
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20.  In India, both oral and injectables vitamin B12 is
available mostly or combination preparation along
with other vitamines , with or without iron.
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21. A yellow crystalline water-soluble vitamin
essential for cell growth and reproduct ion. It functions
as a coenzyme with vitamins B12 in the metabolism and
use of proteins and in the formation of nucleic acids and
heme for hemoglobin.
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22. • Absorption Primarily – Proximal jejunum
conjugates hydrolyse dietary pteroylmonoglutamic
by conjugases.
 Folic acid reduced by dihydrofolate reductase to
THFA.
 Methylated to 5-MeTHFA THFA→ folate
 Rest 5-20mg stored in liver undergoes enterohepatic
circulation
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23.  THFA → Folate cofactors Synthesis of
purine and pyrimidine
Deficiency of Folic Acid:
 Diet lack, malabsorption syndrome, excessive demands in
Pregnancy & anemia, liver disease & renal dialysis, drug
induced, megaloblastic anemia and teratogenic effects .
Doses:
Daily requirement of folic acid 50µg
Pregnancy & lactation :↑200-300µg/day
Therapeutic doses :1-5mg/day
Folinic acid - prevention or in treatment of toxicity from
Methotrexate
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24.  Folic acid - treat folate deficiency by
phenytoinor phenobarbitone .
 Prophylactically given during pregnancy, lactation or
using.
 oral contraceptive
 Given along with vitB12 treat megaloblastic anemia.
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25. 1.To treat megaloblastic anemia due to folate deficiency,
2.Liver disease,
3.Chronic disease
4. Renal dialysis
5. Pregnancy.
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26.  Principles of pharmacology – HL Sharma & KK Sharma.
 Pharmacology – Rang & Dale 5th Edition.
 Text book of pharmacology – K. D. Tripathi.7th Edition.
 Basics & clinical pharmacology – Katzung 11th edition.
 Pharmacology & Pharmacotherapeutics - Satoskar-
21st edition.
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