Download - Obat Anti Anemia
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Antianemia agentsIron
Vit B12
Folic acid
Copper
Pyridoxine,riboflavine
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Iron
Iron-porphyrin ring heme
Essential and non essential iron
Absorbed in duodenum,proxjejenum(ferrous iron)
Normal indiv:0,5-1mg daily
Absorption : vit c,HCl,co,inosin,etionin Absorption: phosphate,antacid, presence
of chelator or complexing agents
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Transported in the plasma bound to
transferrin(specific for ferric iron)
developing erythroid cells in bone marrow Storage: ferritin , hemosiderinRE cells
Elimination: skin epithelial cells,exfoliation
of intestinal mucosal cells, bile, urine,nail,hair
Side effect(intolerance to oral prep):
nausea, epigastric discomf, abd cramps,
constipation, diarrhea
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Indication : treatment/prevent of iron
deficiency anemia.
Definfants, rapid growth child,
pregnancy, lactating, post gastrectomy,
severe small bowel disease(malabsorpt),
blood loss(adult)
Treatment: - oral iron preparations
- parenteral iron preparations
Oral iron corrects the def just as rapidly
and completely as paranteral iron
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Oral prep:- ferrous sulfate
- ferrous gluconate
- ferrous fumarate
200-400 mg daily for 3-6 months
Paranteral prep: Iron Dextran
50 mgelemental iron/ml solution
Note: Normal range of iron serum: 60-160mcgr/dl
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Vit B12 and Folic acid
Vit B12+ folic acidintracellular metab
A def of either vit B12 or folic acid
defective synthesis of DNA in any cell
megaloblastic anemia
Vit B12cyanocobalamin and
hydroxocobalamin(therapeutic use)
Active forms in human: methylcobalamin
and deoxyadenosilcobalaminenzymatic
reactions
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Absorption (oral) of B12intrinsic factor
of castle IFhistamine, cholinergic, corticosteroid,
ACTH, thyroid hormone
Def B12
neurological disorders FAcarrier of single carbon unitpurine,
pirimidine,amino acids interconversion
FA def: chronic alcoholism, oralcontraceptives, anti convulsants,
malnutrition, malabsorption, cytotoxic drug
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R/ vit B12 def:
- initial dose: 100 mcgr IM/5-10 days,
then 100-200 mcgr IM/ month
R/ FA def:
- initial dose: 0,5-1mg/day
10 days,0,1-0,5mg/day
(inj 5mg/ml)
Note: Vit B12: 0,3-1ngr/ml, FA: 4-25ngr/ml
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Erythropoietin
First human hematopoietic growth factor
Stimulates erythroid prolif and different
interacting w/ specific epo receptor Produced using recombinant DNA
technology
Ind: CRF w/ severe anemia Dose: 50-150 IU, 3x /week
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Obat anti anemia
1. Besi2. Vitamin B12
3. Asam folat
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Besi(Fe)
Esensial dan non esensial(cadangan)
Absorpsi bentuk fero
Absorpsi :Co, inosin, etionin,Hcl, dansenyawa asam
Absorpsi : fosfat, antasida
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Cadangan: feritin(60%) dan
hemosiderin(40%)sel sel RE Ekskresidesquamasi sel-sel epitel,
kerigat, kuku, rambut,urin, feces
Efek samping intoleransi sediaan oral:- mual dan nyeri lambung
- konstipasi
- diare dan kolik intestinal
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Sediaan dan posologi
OralFe-sulfat, Fe-fumarat,Fe glukonat)
ParenteralIron dextran(imferon)-----
50mg/ml
Dosis R/berat anemia
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Vitamin B12
Cianokobalamin dan hidroksokobalamin
Bentuk aktif: metilkobalamin dan 5-deoksi
adenosilkobalamin
Fungsi :metabolisme intra sel
Absorpsi memerlukan FIC(Faktor Intrinsik
Castle) Defisiensigangguan metabolisme intra
sel asam folat & neurologic disorders
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Dosis terapi tergantung berat anemia
Awal100 mic/hr selama 5-10 hr (IM)penunjang100-200 mic/bln sampai
remisi lengkap
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Asam folat
Carrier single carbon unit Bentuk aktif: folinic acid
= asam tetrahidrofolat
Fungsi sbg carrier carbon utk sintesis purin-pirimidin dan interkonversi asam2 amino
Defisiensi folattransfer carbonunit
terganggu
sisntesis proteinterganggusintesis purin-pirimidinDNA
mitosis anemia megaloblastik
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Defisiensi folattidak disertai ggn
neurologik Sediaan: tablet dan injeksi(sk,im)
Dosis R/awal 0,5-1mg/hr selama 10 hr
penunjang 0,1-0,5 mg/hr
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Erythropoietin
First human hematopoietic growth factor
Stimulates erythroid prolif and different
interacting w/ specific epo receptor Produced using recombinant DNA
technology
Ind: CRF w/ severe anemia Dose: 50-150 IU, 3x a week