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Understand the clinical pharmacology of iron, vitamin B12, folic acid, and hematopoietic growth factors for treating anemias. Learn about absorption, metabolism, therapies, adverse effects, and dosage requirements. Explore the use of erythropoietin and colony-stimulating factors in hematopoiesis.
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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