haematinics general introduction

1. HAEMATINICS
&
RECENT DISCOVERED DRUG
by
AmritAnshu nihAl
DepArtment of phArmAcy
itm university,GwAlior

2. Haematinics
Haematinics are substances which required in
formation of blood, & are used for treatment of
Anemia.
Anaemia is characterized by low haemoglobin count. WHO
defines anaemia as Haemoglobin levels less than 13 g/dl in
males & less than 12 g/dl in females. In adults, the lower
extreme of the normal haemoglobin is taken as 14.0 -16 g/dl for
males and 12 -14 g/dl for females.
Include :
 iron,
 vitamin B12
 folic acid

3. Transportation & storage of iron
 Essentials of Medical pharmacology by KD Tripathi – 7th
Edition, JAYPEE, 2013

4. Iron – Transport & storage
 Diet – 10 to 20 mg – absorbed from all over the Intestine (more
from upper part)
 2 forms – haeme and Inorganic
 Haeme – minor form of dietary Iron but absorbed better without any
transporter
 Inorganic – in ferric form but absorbs lesser – converted to ferrous
form in Intestine for absorption – needs transporter
 Divalent metal transporter (DMT1) and Ferroportin (FP)
 Factors increasing absorption – acid, reducing substances –
ascorbic acid, amino acid etc. and meat
 Factors impending absorption – alkali (antacids), Phosphates,
phytates, tetracycline and presence of other food
 Mucosal block: from mucosal cell – transported to plasma or
remains stored in mucosal cell by forming ferritin - Ferritin
curtain
 Balance between those two – detremines how much Iron to enter
body - by haematopoietic transcription factor

5. Iron:-
*An essential body constituent,
*total body iron in an adult is 2.5-5g(3.5-avg.)
*if<50mg/kg,distributed in to
*heamoglobin:- 66%
*stored as ferritin &heamosiderin;-25%
*myoglobin:- 3%
*parenchymal ron(enzume etc.):- 6%
PREPARATION AND DOSE
Oral preparations:
1. Ferrous sulfate: is cheapest (FERLOSATE-
200mg.tab.)
2. Ferrous gluconate:(12% iron) FERRONICUM-
300MG. TAB.
3. Ferrous fumarate:(33% iron) NORI-A 200mg.tab.

6. Parenteral preparations:
Iron therapy by injecting is indicated only when
1.Oral is not tolerated
 2.Failure to absorb oral iron
 3.In presence of severe chronic bleeing
1.Iron dextran:50mg. (Elemental iron/ml.)
IMFERON inj.-100mg/2ml-IM,IV
2. Iron sorbitol citric acid complex 75mg/day
FERIMAX-amp.(drug+folic acid-
0.75mg+hydrocobalamin-75ug

7. Adverse effects of oral iron
Constipation due to astringent effect, Epigastric pain,
Heartburn, Nausea&Vomiting, bloating, Teeth staining,
Metallic taste, Start with low dose then increase the dose
higher.
Prevention: Takes immediately after or with
meals
Staining of teeth ( with liquid formulations)
Blackening of stools

8. Adverse effects of parenteral iron :
 Pain at site of injection (I.M.)
 Pigmentation of skin, (especially in old age patient)
 Fever, headache, joint pain, chest pain
 Hypersensitivity reaction

9. Therapeutic uses of iron
1. Treatment of iron deficiency anaemia
2. Prophylaxis of iron deficiency anaemia
Pregnancy, lactation
Infants and growing children
Professional blood donors

10. Cynocobalamin and Hydroxocobalamin are complex cobalt containing
compound present in diet and reffered to as VIT. B12
SOURCE: seafish, egg yolk,meat cheese , only vegetable source is
PULSES
REQUIREMENT:- 1-3ug,pregnancy and lactation 3-5ug
Preparations:
Cyanocobalamin
(NEUROBION FORT INJ.-1000ug/3m.)
Hydroxocobalamin
(BICISULE cap.)
Methylcobalamin:-(methyl B12)
This preparation of vitB12 in a dose of 1.5mg/day
BIOCOBAL,DIACOBAL,METHYL COBAL0.5mg.tab.
Vitamin B12

11. Uses of vitamin B12
1.Treatment and prophylaxis of vitamin B12
deficiency (megaloblastic anemia)
2. Vit B12 injection in pernicious anemia
(condition where Vit B12 is not absorbed from the
stomach)
*Mega dose of vit.B12 has also used in neuropathies,&
psychiatric disease,

12. FOLIC ACID
Yellow crystal & insoluble in water but it’s sodium salt freely
water soluble.
Chemically it is PGA(pteroyl glutamic acid) consisting of
petridine+PABA+glutamic acid
SOURCE:-green leaf, spinach,egg,meat,milk etc
REQUIREMENT:-in adult<0.1mg/day,but during pregnancy or
any high metabolic activity0.8mg/day.
Preparations
 Folic acid:-(falvite,folitab 5mg.tab.)
 Folinic acid :RECOVORIN 15mg.tab,50mg.vial for
inj.

13. Therapeutic uses
- Megaloblastic anemias due to folic acid
deficiency
- As supplement during pregnancy
- To prevent deficiency:
 Antiepileptic therapy
 Methotrexate toxicity:-folic acid is an active coenzyme
form which does not need to be reduced by DHFRase
inhibitor;its toxicity is not counteracted by folic acid, but
anta gonised bu folinic acid.

14. Current discovered Haematinics
 POLYHERBAL FORMULATION IN hgcl2
INDUCED ANAEMIA IN
LABORATORY ANIMALS shows Haematinics activity
. *Composition of Haema Tablet: Amalaki 60 mg, Haritaki 60 mg,
Mandur bhasma 40 mg, Mustak 60 mg, Shunthi 60 mg, Vidang 60 mg,
Bibhitaki 60 mg, Indryava 60 mg,Suvarna makshik bhasma 40
 aqueous extract of Hibiscus cannabinus leaves have
haematinic properties.

15. E-mail:-a.nihal888@gmail.com