Pharmacological Treatment of Anemia PDF

# Pharmacological Treatment of Anemia ## Types of Anemia ### ↓ RBC production - **Iron-deficiency anemia (IDA)** - **Diets poor in iron** - **↓ absorption:** - **A) Intestinal conditions:** - 1) inflammatory bowel disease, - 2) bowel resection....

# Pharmacological Treatment of Anemia ## Types of Anemia ### ↓ RBC production - **Iron-deficiency anemia (IDA)** - **Diets poor in iron** - **↓ absorption:** - **A) Intestinal conditions:** - 1) inflammatory bowel disease, - 2) bowel resection. - **B) Achlorhydria** - **AI/ACD anemia** - Anemia of inflammation and chronic disease - 1. **Cancer** → due to both malignancy and myelosuppressive antineoplastic therapy. - 2. **Chronic kidney disease (CKD):** → dysregulation of iron and erythropoietin (EPO) hemostasis. - 3. **Chronic immune-related diseases** e.g. rheumatoid arthritis and systemic lupus erythematosus. - 4. **Infection** →e.g. HIV ### Nutritional deficiencies: - iron, vitamin B12 and folic acid - **o↓ iron** → **↓ Hb synthesis** → **↓ RBC production.** - **o Folic acid and vitamin B12 (required for the formation of DNA)**→ **↓ DNA synthesis** → **↓ RBC production** ### • Pernicious anemia: - Malabsorption of vitamin B12 due to the absence of intrinsic factor, a glycoprotein produced by gastric parietal cells that binds to vitamin B12. ### • Excessive iron loss: - 1. excessive menstruation, - 2. ulcers or neoplastic lesions - 3. excessive bleeding following surgery or trauma ### Dysregulation of Iron Homeostasis in AI/ACD anemia - **1. Activation of the immune system:** - **A. ↑ IL-6** → **↑ expression of hepcidin** (an acute-phase protein) → ↓ iron absorption from GIT and iron release from macrophages. - **B. ↑ cytokines** → ↓ proliferation and differentiation of erythroid precursors. - **2. production and responsiveness to EPO** patients with CKD. - **3. erythropoiesis** due to infiltration of the bone marrow by cancer. ## SYMPTOMS OF ANEMIA | Category | Symptoms | | -------------- | --------------------------------- | | Respiratory | Shortness of breath | | Digestion | Change in stool color | | Muscle | Pain | | Heart | Fainting and fatigue, Angina and heart attack | | Spleen | Enlargement | | Skin | Yellowing | ## Home Remedies For Anemia - Pomegranate - Banana - Legumes - Nuts - Dates - Fenugreek - Bottle Gourd Soup - Tomatoes - Spinach - Beetroot and Apple Juice - Liver - Whole Grains ## Pharmacological Treatment ### Iron-Deficiency Anemia - **1) Oral Iron Therapy** - Ferrous sulphate - **Parenteral** - CosmoFer - Venofer - Hemafer ### 2-Vitamin B12 deficiency Anemia - **Kinetics**: - **Vitamin B12 (Cyanocobalamin)** → absorbed completely following parenteral administration - **oral vitamin B12** → poorly absorbed via the GIT ## Vitamin B12 Rich Foods - Fish - Almonds - Crab - Milk - Red Meat - Eggs - Chicken - Cheese ## 3-Folic Acid Deficiency Anemia - Feroglobin - Folic Acid ## Porphyria - **“mad king who lost America”** - King George III ruled England during the period of American revolution. - He was a victim of this disease AIP and possessed the characteristic manifestations and was considered mad. - The decisions taken by the deranged King due to acute intermittent porphyria had led to a war followed by American Independence.