Pharmacology: Anemia Treatment

Introduction to Anemias

• Anemia is a condition marked by a deficiency of red blood cells or hemoglobin, leading to a lack of oxygen in the body.
• Types of anemia include iron deficiency anemia, vitamin B12 deficiency anemia, folic acid deficiency anemia, sickle cell anemia, and thalassemia.

Erythropoiesis

• The production of red blood cells requires iron, vitamin B12, and folic acid.
• Erythropoietin hormone, produced by the kidneys, regulates erythropoiesis.

Iron

• Iron is necessary for hemoglobin production.
• Iron deficiency leads to small red blood cells with low hemoglobin (microcytic hypochromic anemia).

Vitamin B12 and Folic Acid

• Vitamin B12 and folic acid are necessary for DNA synthesis.
• Deficiency in either leads to abnormal production and maturation of erythroid precursor cells (megaloblastic anemia).

Iron Deficiency Anemia

• Causes: poor diet, chronic blood loss, pregnancy, or rapid growth.
• Symptoms: fatigue, pallor, dizziness, shortness of breath.
• Treatment: iron supplements (oral or parenteral).
• Iron therapy options: ferrous sulfate, ferrous gluconate, ferrous fumarate (oral); iron dextran, iron sucrose, ferric carboxymaltose (parenteral).
• Side effects: nausea, constipation, black stools (oral); allergic reactions (parenteral).

Vitamin B12 Deficiency Anemia

• Causes: malabsorption (pernicious anemia), dietary deficiency (vegans), gastric surgery.
• Symptoms: fatigue, weakness, neurological issues (paresthesias, ataxia).
• Treatment: vitamin B12 injections (cyanocobalamin, hydroxocobalamin).
• Vitamin B12 therapy options: parenteral vitamin B12 injections (cyanocobalamin, hydroxocobalamin); oral therapy with high doses (for those who refuse injections).

Folic Acid Deficiency Anemia

• Causes: poor diet, alcoholism, malabsorption, increased demand (pregnancy).
• Symptoms: fatigue, weakness, pallor.
• Treatment: oral folic acid supplements.
• Folic acid therapy: to reverse anemia and replenish stores; prevention through supplementation for high-risk groups (pregnant women, patients with hemolytic anemia).

Sickle Cell Anemia

• Cause: genetic mutation in hemoglobin (HbS).
• Symptoms: painful crises, anemia, increased risk of infections.
• Treatment: hydroxyurea, pain management, blood transfusions.
• Hydroxyurea benefits: decreases frequency of painful crises, reduces need for transfusions.
• Hydroxyurea side effects: bone marrow suppression, gastrointestinal issues, teratogenicity.