Haematinics

1. Presented By :
pankaj rana
Nurse practioner
SRHU

2. Haematinics
These are substances required in the
formation of blood & are used for
treatment of anaemias.
Improving the condition of the
blood.
Also called haematinic & agent that
stimulates the production of red
blood cells or increase the amount
of haemoglobin in the blood.

3.  Iron is an essential mineral that is
required for human life.Much of the iron
in the body is found in red blood cells.
Distribution of iron in body:
 Haemoglobin – 66%
 Iron stores as ferritin & haemosiderin –
25%
 Myoglobin – 3%
 Parenchymal iron – 6%

4.  Adult male : 0.5-1 mg .
 Adult female : 1-2 mg.
 Infants : 60 /kg.
 Children : 25 /kg.
 Pregnancy (last 2 trimesters) : 3-5 mg.

5. The major part of dietary iron is
inorganic & in the ferric form. It
needs to be reduced to the ferrous
form before absorption.
Its absorption occurs all over in the
intestine.

6.  Iron in transported into erythropoietic & other
cells .
 Iron dissociated from the complex at the acidic
pH of the intracellular vesicles, the released iron
is utilized for haemoglobin synthesis .
 Iron is stored in RE cells in liver, spleen bone
marrow, also in hepatocytes & myocytes as
ferritin .
 Iron is excreted through sweat ,very little in
urine, desquamated skin, in some RBCs and in
bile(all lost in faeces).

7. Oral Iron:
 1.Ferrous Sulfate- Fersolate 200mg tab.
 2.Ferrous gluconate- Ferronicum 300mg
tab,400mg/15ml.
 3.Ferrous fumarate- NORI-A 200mg tab.
 4.Colloidal ferric hydroxide-Neoferum 200mg
tab, 400mg/5ml liquid, 100mg/ml drops.

8. Parenteral Iron-
 IV ,IM.
 1. Iron dextran:Imferon 2ml ampoule.
 2. Iron sorbitol citric acid complex- Jectofer
1.5ml ampoule.
Adverse effects-
 Epigastric pain
 Heartburn
 Nausea ,vomiting
 Metallic taste
 Constipation

10.  Deficiency of vit B12 & folic acid , which are
B group vitamins , result in megaloblastic
anaemia characterized by the presence of
large red cell precursors in bone marrow &
their large & shortlived progeny in peripheral
blood.vit B12 & folic acid are therefor called
maturation factors.

11.  Cyanocobalamin & hydroxocobalamin are
complex cobalt containing compounds
present in the diet & referred to as vit
B12.
Daily requirement:
 1-3 mg,pregnancy & lactation 3-5 mg.

12.  Vit B12 is transported in blood in
combination with a specific β globin
transcobalamin 2nd.
 Vit B12 is especially taken up by liver cell &
stored about 2/3 to 4/5 of body’s content is
present liver.
 It is excreted mainly in bile & urine.
Doses:
 Cynocobalamin:35mg/5ml liq.
,100,500,1000mg inj.Redisol.
 Hydroxocobalamin:1000mg inj. Redisol-H.
 Methylcobalamin:0.5mg tab.Biocobal.

13.  It occurs as yellow crystals which are
insoluble in water, but its sodium salt is
freely water soluble.
Daily requirement:
 In adult is <0.1mg but dietary allowance
of 0.2mg/day is recommended.
 During pregnancy , lactation 0.8mg/day is
considered appropriate.

14.  Folic acid is present in food as polyglutamate
, the additional glutamate residues are split
off primarily in the upper intestine before
being absorbed.
 It is transported in blood mostly as methyl
THFA which is partly bound to plasma
protein.
 Folic acid stored in cell as polyglutamates.
 Liver takes up a large part & secretes
methyl-THFA in bile which is mostly
reabsorbed from intestine.

15.  Folic acid : folvite , folitab 5mg tab.
 Dose : therapeutic 2 to 5 mg/day ,
prophylactic 0.5mg/day.
 Folinic acid: calcium leucovorin , 3mg/ml.
inj. & fastovorin 50mg vial.
Deficiency-
 Malabsorption
 Chronic alcoholism

16. B12 cyanocobalamin:
 Client with gastric,ileal resections, small
bowel disease or malabsorption require
parental use.
Iron :
 Best to give on empty stomach but can give
with food to decrease gastric upset.
 Assess haemoglobin levels & bowel
movement as constipation is common.
Folic acid:
 Contraindicated in uncorrected pernicious
anemia.

17. Thank you