1. Aneamia
Presented By Miss Sudipta Roy
Associate Professor
East Point College of Pharmacy Bangalore

2. • The word comes from the greek which means lack
of blood. An means without and emia means
blood.
• Definition :
• Anemia is defined as a decrease in the total amoun
of the red blood cells (RBCs) or hemoglobin in
blood.It is also defined as lower ability of blood to
carry oxygen.
• or
• Anemia is defined as a hemoglobin cencentration in
the blood below the lower limit of the normal

3. Normal Hemoglobin (Hb) value:
• In Male individuals : 13 gm/dl
• In female individuals : 11.5 gm/dl
• In newborn infants : 15 gm/dl
• At 3 months : 9.5 gm/dl
• The tissues of the human body need a regular
supply of oxygen to the body and lives for 120
days.

4. • Red blood cell
• Oxygen from lungs
• Hemoglobin molecules
• Oxygen bonded with hemoglobin molecules
• Oxygen released to tissue cells

5. • When they die the iron , they contain is returned to
the bone marrow and is used to create new red
blood cells. Anemia develops when heavy bleeding
causes a significant iron loss or when the
production of red blood cells slows down or they
are destroyed at fast rates.
• In anemia , the body does not enough oxygen rich
blood. As a result , the person may feel tired and
have other symptoms. With severe or long-lasting
anemia . A lack of oxygen in the blood can damage
the vital tissues of heart, brain and other organ of
the body.

6. Causes of Anemia.
• Anemia is caused by the following reasons :
• Blood loss
• Decrease in rate of RBC production
• High rate of RBC destruction
• Blood loss :
• Blood loss may be due to the following reasons
• :
• Heavy menstrual period in women
• Surgery
• Trauma
• Cancer

7. Decrease in Rate of RBC
production.
• Mainly two factors can prevent the from making
enough red blood cells. These are Acquired cause
and Inherited Cause.
• Acquired cause include :
• Poor diet (especially poor in iron and folic acid)
• Hormonal imbalance (Poor secretion of
erythropoetin from the kidneys)

8. • High rate of RBC Destruction :
• In various conditions the rate of RBC destruction
becomes high. These conditions may also be
inherited or acquired.
• When spleen gets diseased/enlarged the of RBC
destruction becomes high.
• Examples of inherited conditions that can cause the
body to destroy too many red blood cells include
sickle cell anemia , thalassemia , hemolytic anemia.
• These conditions create defects in the blood cells
that cause them to die faster than healthy red

9. Symptoms of Anemia .
• Symptoms may include :
• Fatigue
• Pale or yellowish skin
• Shortness of breath
• Light-headedness
• Dizziness
• Weakness
• Irregular heartless
• Chest Pain
• Cold hands and feet

10. • Iron deficiency anemia is a common type of anemia in which blood lacks
adequate healthy red blood cells due to deficiency of iron.
• Iron is an essential mineral that is needed to form hemoglobin (an oxygen
carrying protein) inside red blood cells.
• Definition : Iron deficiency anemia (IDA) is a condition in which the body
lack enough red blood cells to transport oxygen to the whole body as a
result iron deficiency anemia produces tiredness and shortness of breadth.
• or
• Aneamia is defined as a hemoglobin concentration below a specified cut-off
point that cut off point depends on the age , gender , physiological status ,
smokinghabits and altitude at which the population being assessed lives.
• WHO defines aneamia in children aged under 5 years and pregnant women
as a heamoglobin concentration <110 g /L at sea level and aneamia in non-
prolonged women as a heamoglobin concentration <120 g/L.

11. Distribution of IRON in Body
• Iron is distributed in active metabolic and storage
pools. Total body iron is about 3-4 gm. This amount
of iron is availble in two forms -
• Functional Form of Iron (75%)
• Hemoglobin 2 g (in men) and 1.5 g (in women)
• Myoglobin : 200 mg
• Respiratory enzymes (as cytochromes ) : 150 mg
• 2. Non-Functional Form of Iron (25%) :
• Free iron is very toxic .So iron is bound to proteins
(non-heme metaloproteins) that allows it to be
transported and stored in non-toxic forms.

12. • Transferrin : 250-300 mg (For transport of iron in Blood) .
• Ferritin : 1 g (in men ) and 0.6 g (in women ) - For storage of iron in
tissues.
• Hemosiderin : 300 mg (For storage)
• Functions of Iron :
• Iron performs several functions in human body .
• These are --
• It is carrier of oxygen from lung to tissues
• It transports electrons within cells.
• It acts as a co-factor for essential enzymatic reactions such as :
• Neurotransmission
• Synthesis of steroidal hormones
• Synthesis of bile salts
• Detoxification process in the liver

13. Etiology .
• Iron deficiency anemia is usually due to :
• 1. Blood loss : Blood loss may be due to following
reasons :
• Menorrhagia (abnormally heavy or prolonged
bleeding)
• Chronic internal bleeding
• Surgery
• Trauma
• Cancer
• Decrease iron intake

14. • Decrease Iron Absorption :
• Absorption of iron can be decreased due to :
• Intestinal disorders such as Crohn's disease, celia
disease
• Reular use of stomach acid blockers
• Certain food like milk , tea , coffee etc.

15. • Increased Iron Requirements:
• It may be due to -
• Juvenile Age
• Pregnancy
• Lactation

16. • Pathophyiology :
• Iron deficincy occurs when the body's iron stores
are deplted and a restricted supply of iron to
various tissues becomes apparent.If not corrected ,
iron deficiency can lead to iron deficiency anemia
,which is a condition defined by a low hemoglobin
concentration in the blood. Iron deficiency
commonly occurs in three stages.

17. • Stage 1 : Diminished Tota Body Iron Content :
• This stage is identified by reduction in bone
marrow iron stores . Level of iron in hemoglobin
and serum remain normal but serum ferritin falls to
<20 ng/ml.
• Serum ferritin concentration typically correlates
well with total body iron stores. However , within
this stage transferrin level rises to increase the
absorption of iron.

18. • Stage 2 : Reduced Red Blood Cell Formation :
• This stage occurs when the iron supply is
insufficient to support the formation of red blood
cells . So, in this stage erythropoesis is impaired.
Erythropoiesis is impaired when serum iron falls to
below 50 mcg/dl and transferrin saturation to less
than 16 % . High levels of a blood marker called zinc
protoporphyrin (ZPP) can indicate this stage. When
iron is not readily available , zinc is used in its place,
producing ZPP.

19. • Iron deficieny Anemia :
• In this final stage , hemoglobin concentration is
affected and drops below the normal range , which
is typically 12 to 15 grams per deciliter for women
and 14 to 16.5 grams per decilter for men. The
normal range , however will be slightly higher for
atheletes living at higher altitudes .

20. Clinical Manifestations.
• The symptoms of moderate to severe iron deficiency anemia can conclude :
• Brittle nails
• Cracks in the sides of mouth
• Extreme Fatigue (tiredness)
• Weakness
• Chest Pain
• Pale skin
• Shortness of breath
• Dizziness or light headedness
• Fast or irregular heartbeat
• Headaches
• Strange cravings to eat items with no nutritional value
• A tingling or crawling feeling in the legs
• Tongue swelling or soreness
• Cold hands and feet

21. • Diagnosis :
• Iron deficiency anemia can be diagnosed with blood tests.
• These include :
• 1. Complete Blood Count (CBC) Test :
• A CBC test measures the amount of cellular or cell related
components in the blood , including
• :
• Red blood cells (RBCs)
• White blood cells (WBCs)
• Hemoglobin
• Hematocrit
• Platelets

22. • Microscopic Examination of Blood :
• These blood tests provide information , including :
• The iron level in blood
• RBC size and color (RBCs are pale if they are
deficient in iron )
• Ferritin level
• Total iron-binding capacity (TIBC)

23. • Treatment :
• Non Pharmacological Treatment :
• Diets that include the following foods can help treat
or prevent iron deficiency :
• Red meat
• Green , leafy vegetables
• Dried fruits
• Nuts
• Iron fortified cereals , breads and pastas
• peas

24. • Additionally , vitamin C may help to absorb iron,
source of vitamin C are a glass of orange juice or
citrus fruit , tomatoes , broccoli, grapefruit , kiwi ,
melons etc.
• Pharmacological Treatment :
• Iron Supplements :
• Iron tablets can help to restore iron levels in your
body . Take iron tablets on an empty stomach , that
helps the body absorb them better. If they upset
your stomach , you can take them with meals .