Drugs for iron deficiency anemia Physiology and hematologic system The hematologic system includes plasma, red blood cells, white blood cells, and platelets. The types of drugs used to treat hematologic disorders include: Hematinic drugs Anticoagulant drugs Thrombolytic drugs Hematinic drugs Provide essential building blocks for RBC production by increasing hemoglobin that is necessary for oxygen transportation. The following drugs are used to treat microcytic and macrocytic anemia: Iron vitamin B12 folic acid. Epoetin alfa is used to treat normocytic anemia. IRON Used to treat iron-deficiency anemia which is the most common form of anemia. Iron preparations include: ferrous fumarate ferrous gluconate ferrous sulfate iron dextran. Pharmacokinetics: Absorbed in the small intestine. The amount of iron absorbed depends partially on the body stores of iron. Enteric-coated preparations decrease absorption. Lymph system absorbs IM injections. Transported by blood and bound to transferrin; stored in liver, spleen, and bone marrow; two-thirds is contained in hemoglobin. Excreted in urine, stool, sweat, and intestinal cell sloughing; secreted in breast milk. Pharmacodynamics: Most important role is the production of hemoglobin. Pharmacotherapeutics: Used to prevent or treat iron deficiency anemia. Given to children 6 months to 2 years old and pregnant women. Treatment lasts 6 months. Drug interactions: Absorption is reduced by antacids, coffee, tea, milk, and eggs. Adverse reactions: Most common is gastric irritation. darkens stool. Drugs for megaloblastic anemia Etiology :- it caused by either folic acid or vitamin B12 deficiency FOLIC ACID Given to treat folic acid deficiency. Preparations include: folic acid and leucovorin calcium. Pharmacokinetics: Absorbed rapidly in the intestine; distributed to all body tissues; metabolized in the liver; excreted in the urine and stool; secreted in breast milk. Pharmacodynamics: An essential component for normal RBC production and growth. A deficiency results in pernicious anemia and low serum and RBC folate levels. Pharmacotherapeutics: Used to treat folic acid deficiency. Patients requiring preventive folic acid therapy include: pregnant women and patients undergoing treatment for liver disease, hemolytic anemia, alcohol abuse, skin disease, or renal failure. Drug interactions: In large doses may counteract the effects of anticonvulsants potentially leading to seizures. Adverse reactions: Erythema, itching, and rash. VITAMIN B12 Used to treat pernicious anemia. Common B12 preparations include: Cyanocobalamin Hydroxocobalamin Pharmacokinetics: Administered orally or parenterally. When a person has a deficiency of intrinsic factor, which is secreted by the gastric mucosa and is needed for vitamin B12 absorption, vitamin B12 deficiency pernicious anemia develops. These people require vitamin B12 injections. Stored in the liver; excreted in the urine. Pharmacodynamics: Essential for cell growth and replication and for the maintenance of myelin throughout the nervous system. Pharmacotherapeutics: Used to treat pernicious anemia, which is a megaloblastic anemia characterized by decreased gastric production of hydrochloric acid and the deficiency of the intrinsic factor (normally secreted by the parietal cells of the gastric mucosa and is essential for vitamin B12 absorption). Drug interactions: Alcohol may decrease the absorption of oral cyanocobalamin. Adverse reactions: No dose-related adverse reactions.