Iron

FeSO4

▪ Ferrous gluconate- 

▪ Ferrous fumarate- 

Iron oral

high elemental Fe content

(325mg - 106mg elemental iron)

Ferrous fumarate-

less irritating Fe salt (325mg -37mg elemental iron)

Ferrous gluconate

high elemental Fe content

(325mg - 106mg elemental iron)

Ferrous fumarate

▪ Iron Dextran (IM or IV)

▪ Iron sorbitol (IM)

▪ Sodium ferric gluconate

▪ Iron sucrose

Iron PARENTERAL

GIT discomfort: Nausea, epigastric discomfort, abdominal cramps, constipation, diarrhea, black stool. They may be minimized by lowering the daily dose or by taking iron tablets immediately after or with meals.

Iron A/E oral

Local pain in the injection site, brown discoloration of tissues (Hemosiderin)

Iron A/E parenteral

(Hemosiderin)

Local pain in the injection site, brown discoloration of tissues

Hemachromatosis

excess iron is deposited in heart, liver, pancreas and other organs cause organ failure and death.

deferoxamine

Acute iron intoxication: parenteral administration of

deferoxamine or

with the newer oral iron chelator deferasirox.

Chronic iron intoxication: For chronic iron intoxication and hematochromatosis are treated with parenteral

Cyanocobalamin

Vitamin B12-

Folic acid

Vitamin B9-

Pernicious anemia

Anemia affect the Neurologic deficit

folic acid

Essential metabolite to produce DNA

Antimetabolites

Inhibit the folic acid synthesis

Tetrahydrofolate

Absorbable

Polynerv, Neurobion

COBALAMIN (Vit B12) brand

COBALAMIN (Vit B12)

Brand: Polynerv, Neurobion

Source: Meat (liver), eggs, & dairy products.

intrinsic factor of castle, a product of the parietal cells of the stomach.

cobalamin is absorbed from the GIT in the presence of…

1. cyanocobalamin

- 2. hydroxocobalamin has a longer circulating half-life

COBALAMIN (Vit B12)

Brand: Polynerv, Neurobion

available in 2 forms:

Mecobalamin (Methycobal)

active form of B12 is now prescribed for the treatment of vitamin B12 deficiency

(Methycobal)

Mecobalamin BN

COBALAMIN (Vit B12)

Brand: Polynerv, Neurobion

Uses:

1- Pernicious & Megaloblastic anemia

2- Neurologic abnormalities

3- Gastrectomy

4- Cyanide poisoning (convert cyanide into cyanocobalamin)

Folvite, Folart, Folicard, Hemarate FA, Fortifer FA

FOLIC ACID (Vit B9)

FOLIC ACID (Vit B9)

Brand: Folvite, Folart, Folicard, Hemarate FA, Fortifer FA

Source: yeast, liver, kidney, & green vegetables.

dihydrofolate reductase

Folic acid is converted to tetrahydrofolate by the action of

neural tube defects

deficiency of folic acid during pregnancy

Achlorhydria

Hookworm infestation

Destroyed parietal cell

Chronic kidney disease 

Decrease levels of erythropoietin 

Hepcidin

Regulation of iron metabolism

Erythropoietin

Produced by the kidneys

ERYTHROPOIETIN

stimulates the production of red cells and increases their release from the bone marrow, through activation of receptors on erythroid progenitors in the bone marrow

1. EPOETIN Alfa (Epogen, Procrit)

2. DARBEPOETIN (Aranesp)

3. Methoxy polyethylene

• Glycol-epoetin beta

ERYTHROPOIETIN

3. Methoxy polyethylene

• Glycol-epoetin beta

a long-lasting form of erythropoietin that can be administered once or twice a month.

DARBEPOETIN (Aranesp)

is a long-acting version of erythropoietin

DARBEPOETIN (Aranesp)

has decreased clearance and has a half-life about three times that of erythropoietin.

DARBEPOETIN (Aranesp)

a glycosylated form of erythropoietin, has a much longer half-life

DARBEPOETIN (Aranesp)

Supplementation with iron may be required to assure an adequate response.

DARBEPOETIN (Aranesp)

The protein is usually administered intravenously in renal dialysis patients, but the subcutaneous route is preferred.

(Epogen, Procrit)

EPOETIN Alfa BN

(Aranesp)

DARBEPOETIN BN

Sickle cell anemia

an inherited red blood cell disorder in which there aren't enough healthy red blood cells to carry oxygen throughout your body

HYDROXYUREA

can relieve the painful clinical course of sickle-cell disease.

THROMBOCYTOPENIA

when you don't have enough platelets, cells in your blood that stick together to help it clot.

THROMBOCYTOPENIA

CAUSES:

1. Aplastic anemia

2. Cancer- Leukemia and Lymphoma

3. Platelet-lowering disease like Wiskott-Aldrich or

May-Hegglin syndromes

4. Viral infection- HIV, chickenpox, rubella

5. Heparin (HIT)

6. Chemotherapy

Polycthemia

⬆ RBC

Anemia

⬇ RBC

Leukemia

⬆ WBC

Thrombocytopenia

⬇ platelet

Thrombocytosis

⬆ WBC