Anemia narration

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Drugs for Deficiency Anemias : 

Drugs for Deficiency Anemias

Objectives : 

Objectives Summarize the roles of erythropoietin, iron, vitamin B12, and folic acid in erythropoiesis (red blood cell production). State the main factor that determines daily iron requirements, and explain how the body adjusts iron uptake from dietary sources to ensure adequate levels yet prevent iron overload. List several foods or food groups that are naturally rich sources of iron. State three common conditions that lead to iron deficiencies, and explain whether it is usually reduced iron delivery or increased iron demand that contributes to the imbalance.

Objectives : 

Objectives Describe the physiologically essential interrelationship between vitamin B12 and folic acid and the major physiologic roles of active folate. Also name the main physiologic roles of each and the signs and symptoms of deficiency. Describe the consequences of vitamin B12 deficiency on neural function; erythrocyte count and appearance (as in a blood smear); coagulation; and immune system function. Summarize the signs and symptoms with which a patient with “pernicious anemia” is likely to present, and discuss therapy for mild, moderate, and severe cases of the disorder. Consider that the hypothetical patient is an adult. Summarize the likely fetal consequences of folate deficiency in the pregnant mother as well as general guidelines about folate supplementation in women, especially during pregnancy. State the trimester(s) in which adequate maternal folate intake is particularly critical.

Drugs for Deficiency Anemias : 

Drugs for Deficiency Anemias Anemia—decrease in erythrocytes (RBC) Number Size Hemoglobin content Causes Blood loss Hemolysis Bone marrow dysfunction – Deficiency of substances essential for RBC formation and maturation

Iron Deficiency : 

Iron Deficiency Most common nutritional anemia Iron essential to hemoglobin Fate in the body Uptake and distribution Uptake into mucosal cells in small intestine Undergo storage within mucosal cells Undergo binding to transferrin Utilization and storage Taken up by cells of the bone marrow Taken up by the liver and other tissues Taken up by muscle

Iron Deficiency : 

Iron Deficiency Fate in the body (cont’d) Recycling—undergoes continuous recycling Elimination—1 mg of iron is excreted each day Regulated through control of intestinal absorption Daily requirements Determined by rate of erythrocyte production Increased during pregnancy Dietary sources Available in foods of plant and animals

Iron Deficiency: Causes, Consequences, and Diagnosis : 

Iron Deficiency: Causes, Consequences, and Diagnosis Imbalance in iron uptake and iron demand Causes Pregnancy Infancy and early childhood Chronic blood loss Consequences Microcytic, hypochromic anemia Diagnosis Presence of microcytic, hypchromic erythrocytes Absence of hemosiderin in bone marrow

Figures 54-1 Stages of red blood cell development. : 

Figures 54-1 Stages of red blood cell development.

Figure 54-2 Fate of iron in the body. : 

Figure 54-2 Fate of iron in the body.

Oral Iron Preparations I: Iron Salts : 

Oral Iron Preparations I: Iron Salts Ferrous sulfate Indications—drug of choice Adverse effects GI disturbances Staining of teeth Toxicity

Oral Iron Preparations I: Iron Salts : 

Oral Iron Preparations I: Iron Salts Drug interactions Antacids Tetracycline Ascorbic acid Other oral iron salts Ferrous gluconate and ferrous fumarate

Vitamin B12 Deficiency : 

Vitamin B12 Deficiency Vitamin B12 (cobalamin) Essential for synthesis of DNA Absorption requires intrinsic factor Elimination takes place very slowly Daily requirement Dietary sources Limited to microorganisms Animal products (liver, dairy products) Fortified foods

Figure 54-4 Relationship of folic acid and vitamin B12 to DNA synthesis and cell maturation. : 

Figure 54-4 Relationship of folic acid and vitamin B12 to DNA synthesis and cell maturation.

Vitamin B12 Deficiencies: Causes, Consequences, and Diagnosis : 

Vitamin B12 Deficiencies: Causes, Consequences, and Diagnosis Causes Regional enteritis Celiac disease Absence of intrinsic factor Consequences Megaloblastic anemia Neurologic damage Demyelination of neurons GI disturbances

Vitamin B12 Deficiencies: Causes, Consequences, and Diagnosis : 

Vitamin B12 Deficiencies: Causes, Consequences, and Diagnosis Diagnosis Measurement of plasma B12 Schilling test

Vitamin B12 Preparations: Cyanocobalamin : 

Vitamin B12 Preparations: Cyanocobalamin Cyanocobalamin Administration Oral, parenteral, intranasal Adverse effects Hypokalemia Long-term treatment With lack of intrinsic factor, vitamin B12 therapy lifelong Potential hazards of folic acid

Folic Acid Anemia : 

Folic Acid Anemia Folic acid Essential factor for DNA synthesis DNA replication Cell division cannot proceed Absorbed in the early segment of the small intestine Significant amounts are excreted daily Daily requirements Dietary sources—all foods

Folic Acid Anemia—Causes and Consequences : 

Folic Acid Anemia—Causes and Consequences Causes Poor diet (alcoholism) Malabsorption syndrome (sprue) Consequences Megaloblastic anemia Neural tube defects

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