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Haematinics

  1. 1. Presented By : pankaj rana Nurse practioner SRHU
  2. 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. 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. 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. 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. 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. 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. 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
  9. 9.  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.
  10. 10.  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.
  11. 11.  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.
  12. 12.  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.
  13. 13.  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.
  14. 14.  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
  15. 15. 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.
  16. 16. Thank you

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