Haematinics : An overview – Iron and their Drugs

Definition :-

‘Haematinics’ means the formation of blood, and are used for treatment of Anemia.

Anaemia occurs when the balance between production and destruction of RBCs is disturbed by:

(a) Blood loss (acute or chronic)

(b) Impaired red cell formation due to:

Deficiency of essential factors, i.e. iron, vitamin B12, folic acid.

(c) Increased destruction of RBC (Haemolytic Anaemia) .

Iron :-

Iron is an essential mineral. “The major reason we need it is that it helps to transport oxygen throughout the body,” says Paul Thomas .

Iron is an important component of hemoglobin, the substance in red blood cells that carries oxygen from your lungs to transport it throughout your body.

Hemoglobin represents about two thirds of the body’s iron. If you don’t have enough iron, your body can’t make enough healthy oxygen-carrying red blood cells .

A lack of red blood cells is called Iron deficiency anemia.

Iron containing fruits / vegetables :-

Distribution of iron in body; Iron is an essential body constituent. Total body iron in an adult is 2.5 – 5 g (Average 3.5 g).

It is more in men (50 mg/kg) than in women (38 mg/kg).

• Haemoglobin (Hb)= 66%
• Iron stores as ferritin and hemosiderin= 25%
• Myoglobin (in muscles)= 3%
• Parenchymal iron (in enzymes, etc.)= 6%

Preparations and dose :-

Oral iron=

• The preferred route of iron administration is oral.
• One way of treating anemia is with oral iron supplements, including pills, capsules, drops, and extended-release tablets.
• The purpose of oral iron supplementation is to treat your symptoms by increasing the levels of iron and hemoglobin in your body.

DRUGS :

1. CONVIRON Cap
2. FESOVIT-SPANSULE Cap
3. FEFOL SPANSULE Cap
4. HEMGLOB syrup (15 ml)
5. AUTRIN Cap
6. DUMASULES Cap
7. HEMSYNERAL Cap
8. ANEMIDOX Cap
9. HEMSI syrup. (5 ml)
10. FERRICARB Cap
11. HBFAST tab
12. HEMATRINE Cap
13. MUMFER syrp (5 ml)
14. POLYRON tab, BIOFER tab POLYFER chewable tab
15. FERROCHELATE syrup (5 ml) )
16. RARICAP tab
17. PROBOFEX Cap
18. DEXORANGE Cap. and Syrup

Adverse Effects of Oral Iron :

Epigastric pain, heartburn, nausea, vomiting, bloating, staining of teeth, metallic taste, colic, etc. Constipation is more common than diarrhoea .

Parenteral iron=

• Parenteral iron therapy is occasionally necessary for patients intolerant or unresponsive to oral iron therapy, for receiving recombinant erythropoietin therapy, or for use in treating functional iron deficiency.
• There are now three parenteral iron products available: iron dextran, ferric gluconate, and iron sucrose.
• Iron requirement (mg) = 4.4 x body weight (kg) x Hb deficit (g/dl)

1) IRON DEXTRAN:

• Iron dextran is a form of the mineral iron.
• Iron dextran is used to treat iron deficiencies and iron deficiency anemia (low red blood cells).

To make sure iron dextran is safe for you, tell your doctor if you have

1. Heart disease
2. Liver disease or kidney disease
3. Rheumatoid arthritis
4. Bleeding or blood clotting disorder such as hemophilia and stomach bleeding
5. Asthma or allergies

How is iron dextran given?

Iron dextran is injected into a vein through an IV. Do not self-inject this medicine.

Iron dextran must be given slowly. Injecting this medicine too quickly can cause serious side effects.

2) SODIUM FERRIC GLUCONATE:

Is a complex injection is used to treat iron deficiency anemia (not enough iron in the blood). It is used in patients with kidney disease who are receiving dialysis and a medicine called epoetin to prevent anemia.

3) IRON SUCROSE:

Iron sucrose is a form of the mineral iron. Iron sucrose is used to treat iron deficiency anemia in people with kidney disease.

Iron sucrose is not for treating other forms of anemia not caused by iron deficiency.

You should not be treated with this medicine if you have ever had an allergic reaction to an iron injection.

Acute Iron Poisoning :-

It occurs mostly in infants and children: 10-20 iron tablets or equivalent of the liquid preparation (> 60 mg/kg iron) may cause serious toxicity in them. It is very rare in adults.

Manifestations are vomiting, abdominal pain, haematemesis, diarrhoea, lethargy, cyanosis, dehydration, acidosis, convulsions, finally shock, cardiovascular collapse and death. In few cases death occurs early (within 6 hours).

Treatment=

To prevent further absorption of iron from gut;

(a) Induce vomiting or perform gastric lavage with sodium bicarbonate solution to render iron insoluble.

(b) Give egg yolk and milk orally: to complex iron. Activated charcoal does not adsorb iron.

Miscellaneous/Adjuvant Haematinics

1. Copper Haeme synthesis is interfered in copper deficiency. However, copper is a trace metal for man and clinical deficiency is very rare. When copper deficiency is demonstrated, 0.5-5 mg of copper sulphate/day may be given therapeutic: prophylactic dose is 0.1 mg It is present in some haematinic combinations .
2. Pyridoxine responsive anaemia is a rare entity. It is due to inherent abnormality in haeme synthesis. Sideroblastic anaemia associated with isoniazid and pyrazinamide (which interfere with pyridoxine metabolism and action) therapy needs to be treated with pyridoxine.
3. Riboflavin Hypoplastic anaemia occurs in riboflavin deficiency which is generally a part of multiple deficiencies in protein-calorie malnutrition.

To Know About Vit B12 and Folic Acid, Click Here.