Agents used in anemias & hematopoietic growth factors

1. Agents used in anemias &hematopoietic growth factors By: S.Bohlooli, Ph.D.

2. Agents used in anemias • Iron • Vitamin B12 • Folic acid

3. Iron • Iron deficiency • most common nutritional cause of anemia • result from inadequate iron intake, malabsorption, blood loss, or an increased requirement, as with pregnancy

4. The Body Content of Iron

5. Pathways of iron metabolism in human beings

6. Absorption, transport, and storage of iron

7. Iron Requirements for Pregnancy

8. Daily Iron Intake and Absorption

9. Clinical pharmacology • Indication for the use of iron • Treatment or prevention of iron deficiency anemia • Treatment • Oral iron therapy • Parenteral iron therapy

10. Some Commonly Used Oral Iron Preparations

11. Oral iron therapy adverse effects • Nausea • Epigastric discomfort • Abdominal cramps • Constipation • Diarrhea

12. 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

13. Vitamin B12

14. The absorption and distribution of vitamin B12

15. Enzymatic reactions that use vitamin B12

16. Enzymatic reactions that use folate

17. 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

18. Folic Acid

19. Enzymatic reactions that use folate

20. 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

21. Hematopoietic growth factors • Erythropoietin • Granulcyte colony-stimulating factor (G-CSF) • Granulcyte-macrophage colony stimulating factor (GM-CSF) • Interleukin 11

22. Clinical Uses of Hematopoietic Growth Factors