Download - Obat anti anemia.ppt
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Antianemia agents Antianemia agents•IronIron
•Vit B12Vit B12
•Folic acidFolic acid
•Copper Copper
•Pyridoxine,riboflavinePyridoxine,riboflavine
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IronIron
• Ironporp!yrin ring !eme
• "ssential and non essential iron
• Absorbed in d#oden#m,prox $e$en#m%ferro#s iron&
• 'ormal indiv(),*1mg daily
• Absorption ( vit c,+Cl,co,inosin,etionin• Absorption( p!osp!ate,antacid, presence
of c!elator or complexing agents
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• -ransported in t!e plasma bo#nd to
transferrin%specific for ferric iron&
developing eryt!roid cells in bone marro.
• /torage( ferritin , !emosiderin 0" cells
• "limination( sin epit!elial cells,exfoliation
of intestinal m#cosal cells, bile, #rine,nail,!air
• /ide effect%intolerance to oral prep&(
na#sea, epigastric discomf, abd cramps,
constipation, diarr!ea
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• Indication ( treatmentprevent of iron
deficiency anemia3
• 4ef infants, rapid gro.t! c!ild, pregnancy,
lactating, post gastrectomy, severe small
bo.el disease%malabsorpt&, blood loss%ad#lt&
• -reatment( oral iron preparations
parenteral iron preparations
• 5ral iron corrects t!e def $#st as rapidly and
completely as paranteral iron
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• 5ral prep( ferro#s s#lfate
ferro#s gl#conate
ferro#s f#marate
• 2))6)) mg daily for 78 mont!s
• Paranteral prep( Iron 4extran
*) mgelemental ironml sol#tion
'ote( 'ormal range of iron ser#m( 8)18) mcgrdl
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Vit B12 and Folic acidVit B12 and Folic acid
• Vit B129 folic acid intracell#lar metab
• A def of eit!er vit B12 or folic acid defective
synt!esis of 4'A in any cell megaloblastic
anemia
• Vit B12 cyanocobalamin and
!ydroxocobalamin%t!erape#tic #se&
• Active forms in !#man( met!ylcobalamin anddeoxyadenosilcobalamin en:ymatic reactions
•
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• Absorption %oral& of B12 intrinsic factor
of castle• IF !istamine, c!olinergic, corticosteroid,
AC-+, t!yroid !ormone
• 4ef B12 ne#rological disorders• FA carrier of single carbon #nit p#rine,
pirimidine,amino acids interconversion
• FA def( c!ronic alco!olism, oralcontraceptives, anti conv#lsants,
maln#trition, malabsorption, cytotoxic dr#g
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• 0 vit B12 def(
initial dose( 1)) mcgr I;*1) days,
t!en 1))2)) mcgr I; mont!
• 0 FA def(
initial dose( ),*1mgday
1) days, ),1),*mgday
%in$ *mgml&
• 'ote( Vit B12( ),71ngrml, FA( 62*ngrml
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"ryt!ropoietin"ryt!ropoietin
• First !#man !ematopoietic gro.t! factor
• /tim#lates eryt!roid prolif and different
interacting . specific epo receptor • Prod#ced #sing recombinant 4'A
tec!nology
• Ind( C0F . severe anemia• 4ose( *)1*) I<, 7x .ee
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5bat anti anemia5bat anti anemia
1313 BesiBesi2323 Vitamin B12Vitamin B12
7373 Asam folat Asam folat
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Besi%Fe&Besi%Fe&
• "sensial dan non esensial%cadangan&
• Absorpsi bent# fero
• Absorpsi (Co, inosin, etionin,+cl, dansenya.a asam
• Absorpsi ( fosfat, antasida
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• Cadangan( feritin%8)=& dan
!emosiderin%6)=& sel sel 0"• "sresi des>#amasi selsel epitel,
erigat, ##, ramb#t,#rin, feces
• "fe samping intoleransi sediaan oral( m#al dan nyeri lamb#ng
onstipasi
diare dan oli intestinal
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/ediaan dan posologi/ediaan dan posologi
• 5ral Fes#lfat, Fef#marat,Fe gl#onat&
• Parenteral Iron dextran%imferon&
*)mgml
• 4osis 0 berat anemia
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Vitamin B12Vitamin B12
• Cianoobalamin dan !idrosoobalamin
• Bent# atif( metilobalamin dan *deosi
adenosilobalamin
• F#ngsi (metabolisme intra sel
• Absorpsi memerl#an FIC%Fator Intrinsi
Castle&• 4efisiensi gangg#an metabolisme intra
sel asam folat ? ne#rologic disorders
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• 4osis terapi tergant#ng berat anemia
• A.al 1)) mic!r selama *1) !r %I;& pen#n$ang 1))2)) micbln sampai
remisi lengap
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Asam folat Asam folat
• Carrier single carbon #nit• Bent# atif( folinic acid
@ asam tetra!idrofolat
• F#ngsi sbg carrier carbon #t sintesis p#rinpirimidin dan interonversi asam2 amino
• 4efisiensi folat transfer carbon#nit
tergangg#
sisntesis proteintergangg#sintesis p#rinpirimidin 4'A
mitosis anemia megaloblasti
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• 4efisiensi folat tida disertai ggn
ne#rologi• /ediaan( tablet dan in$esi%s,im&
• 4osis 0 a.al ),*1mg!r selama 1) !r
pen#n$ang ),1),* mg!r
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"ryt!ropoietin"ryt!ropoietin
• First !#man !ematopoietic gro.t! factor
• /tim#lates eryt!roid prolif and different
interacting . specific epo receptor • Prod#ced #sing recombinant 4'A
tec!nology
• Ind( C0F . severe anemia• 4ose( *)1*) I<, 7x a .ee