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Agents used in anemias & hematopoietic growth factors. By: S.Bohlooli, Ph.D. Agents used in anemias. Iron Vitamin B12 Folic acid. Iron. Iron deficiency most common nutritional cause of anemia
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Agents used in anemias &hematopoietic growth factors By: S.Bohlooli, Ph.D.
Agents used in anemias • Iron • Vitamin B12 • Folic acid
Iron • Iron deficiency • most common nutritional cause of anemia • result from inadequate iron intake, malabsorption, blood loss, or an increased requirement, as with pregnancy
Clinical pharmacology • Indication for the use of iron • Treatment or prevention of iron deficiency anemia • Treatment • Oral iron therapy • Parenteral iron therapy
Oral iron therapy adverse effects • Nausea • Epigastric discomfort • Abdominal cramps • Constipation • Diarrhea
Clinical toxicity • Acute iron toxicity • Necrotizing gastroenteritis • Vomiting, abdominal pain, bloody diarrhea • Followed by shock, lethargy, dyspnea • Severe metabolic acidosis, coma, death • Chronic iron toxicity (hemochromatosis) • Deposit of iron in the heart, liver, pancreas • Can lead to organ failure and death
Vitamin B12: clinical pharmacology • Treat or prevent deficiency • Megaloblastic anemia • Neurologic syndrome • Degeneration of myelin sheaths • Disruption of axons in the dorsal and lateral horns of spinal cord and in peripheral nerves • Most cause of deficiency: • Pernicious anemia, partial or total gastroctomy • Disease affect the distal ileum: • Inflammatory bowel disease • Small bowel resection
Folic acid: Clinical pharmacology • Deficiency • result in megaloblastic anemia • Often caused by inadequate dietary intake • Pregnant woman has increased folate requirement • A dose of 1 mg is sufficient
Hematopoietic growth factors • Erythropoietin • Granulcyte colony-stimulating factor (G-CSF) • Granulcyte-macrophage colony stimulating factor (GM-CSF) • Interleukin 11