UNIT 3 - AGENTS USED IN ANEMIAS AND HEMATOPOIETIC GROWTH FACTORS

Hematopoiesis

is the continuous process of producing all circulating blood cells from hematopoietic stem cells in the bone marrow

200 billion

In healthy adults, the bone marrow produces more than ____ new blood cells every day, and production can increase dramatically in response to increased demand, such as anemia, infection, or thrombocytopenia.

• skull

• vertebrae

• pelvis

• proximal long bones

hematopoiesis occurs primary in the

Erythropoietin (EPO)

stimulates erythrocycte production

Granulocyte Colony-Stimulating Factor (G-CSF)

stimulates neutrophil production

Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF)

stimulates granulocyte and macrophage production

Thrombopoietin (TPO)

stimulates platelet production

Interleukins (e.g.,IL-4,IL-7,IL-15)

promote lymphocyte development

anemia or hypoxemia

Red blood cell production may increase more than 20-fold during

systemic infection

White blood cell production increases markedly during

thrombocytopenia

Platelet production can increase 10–20-fold during

Anemia

is defined as a decrease in the plasma hemoglobin concentration resulting from a reduced number of circulating red blood cells (RBCs) or a decrease in the total hemoglobin content per unit volume of blood

• Fatigue

• Weakness

• Pallor (Pale Skin)

• Shortness of breath (dyspnea)

• Palpitations

• Dizziness

• Insomnia

Anemia Clinical Manifestations

Iron

essential for the formation of hemoglobin, which is responsible for the reversible binding and transport of oxygen from the lungs to tissues

Iron Deficiency

the most common cause of chronic anemia

Microcytic, hypochromic anemia

Therefore, iron deficiency produces:

Pica

craving for substances such as ice, dirt or paper

Koilonychia

spoon-shaped or upward-curved nails

Angular cheilitis

soreness and cracking at the corners of the mouth

Heme iron and Nonheme iron

Dietary iron exists mainly in two forms

Heme iron

is found primarily in meat, particularly in hemoglobin and myoglobin

Heme iron

It is relatively efficiently absorbed because it can enter intestinal cells as part of the heme molecule.

Heme iron

It is relatively efficiently absorbed because it can enter intestinal cells as part of the heme molecule.

Nonheme iron

is found mainly in vegetables, grains, and inorganic iron preparations

Nonheme iron

Nonheme iron

Before absorption, ferric iron (Fe³⁺) must be reduced to ferrous iron (Fe²⁺

Nonheme iron

This reduction facilitates absorption by intestinal epithelial cells.

Iron Preparations

MOAProvides elemental iron needed for hemoglobin synthesis.