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Antianemia agents

•Iron •Vit B12 •Folic acid •Copper •Pyridoxine,riboflavine

etionin • Absorption↓: phosphate.5-1mg daily • Absorption  : vit c.inosin.Iron • Iron-porphyrin ring heme • Essential and non essential iron • Absorbed in duodenum.prox jejenum(ferrous iron) • Normal indiv:0. presence of chelator or complexing agents .antacid.co.HCl.

hemosiderin  RE cells • Elimination: skin epithelial cells. hair • Side effect(intolerance to oral prep): nausea. epigastric discomf. constipation. bile.nail. urine. abd cramps.• Transported in the plasma bound to transferrin(specific for ferric iron) developing erythroid cells in bone marrow • Storage: ferritin . diarrhea .exfoliation of intestinal mucosal cells.

severe small bowel disease(malabsorpt). rapid growth child. pregnancy. blood loss(adult) • Treatment: . • Def infants. lactating. post gastrectomy.parenteral iron preparations • Oral iron corrects the def just as rapidly and completely as paranteral iron .oral iron preparations .• Indication : treatment/prevent of iron deficiency anemia.

• Oral prep:.ferrous gluconate .ferrous sulfate .ferrous fumarate • 200-400 mg daily for 3-6 months • Paranteral prep: Iron Dextran 50 mg elemental iron/ml solution Note: Normal range of iron serum: 60-160 mcgr/dl .

Vit B12 and Folic acid • Vit B12+ folic acid intracellular metab • A def of either vit B12 or folic acid defective synthesis of DNA in any cell megaloblastic anemia • Vit B12 cyanocobalamin and hydroxocobalamin(therapeutic use) • Active forms in human: methylcobalamin and deoxyadenosilcobalamin enzymatic reactions • .

oral contraceptives. corticosteroid.amino acids interconversion • FA def: chronic alcoholism. malabsorption. anti convulsants. cholinergic.• Absorption (oral) of B12 intrinsic factor of castle • IF histamine. cytotoxic drug . malnutrition. ACTH. pirimidine. thyroid hormone • Def B12 neurological disorders • FA carrier of single carbon unit purine.

5-1mg/day 10 days.1-0. FA: 4-25ngr/ml .3-1ngr/ml. then 100-200 mcgr IM/ month • R/ FA def: .initial dose: 0.• R/ vit B12 def: . 0.initial dose: 100 mcgr IM/5-10 days.5mg/day (inj 5mg/ml) • Note: Vit B12: 0.

3x a week .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.

Vitamin B12 3. Asam folat .Obat anti anemia 1. Besi 2.

Besi(Fe) • Esensial dan non esensial(cadangan) • Absorpsi bentuk fero • Absorpsi :Co. inosin. antasida .Hcl. etionin. dan senyawa asam • Absorpsi : fosfat.

diare dan kolik intestinal . feces • Efek samping intoleransi sediaan oral: . kuku.urin.mual dan nyeri lambung .konstipasi . kerigat.• Cadangan: feritin(60%) dan hemosiderin(40%)  sel sel RE • Ekskresi desquamasi sel-sel epitel. rambut.

Fe-fumarat.Sediaan dan posologi • Oral Fe-sulfat.Fe glukonat) • Parenteral Iron dextran(imferon)----50mg/ml • Dosis R/  berat anemia .

Vitamin B12 • Cianokobalamin dan hidroksokobalamin • Bentuk aktif: metilkobalamin dan 5-deoksi adenosilkobalamin • Fungsi :metabolisme intra sel • Absorpsi memerlukan FIC(Faktor Intrinsik Castle) • Defisiensi gangguan metabolisme intra sel asam folat & neurologic disorders .

• Dosis terapi tergantung berat anemia • Awal 100 mic/hr selama 5-10 hr (IM) penunjang 100-200 mic/bln sampai remisi lengkap .

Asam folat • Carrier single carbon unit • Bentuk aktif: folinic acid = asam tetrahidrofolat • Fungsi sbg carrier carbon utk sintesis purinpirimidin dan interkonversi asam2 amino • Defisiensi folat transfer carbonunit terganggusisntesis protein terganggusintesis purin-pirimidin↓ DNA ↓  mitosis ↓ anemia megaloblastik .

• Defisiensi folat  tidak disertai ggn neurologik • Sediaan: tablet dan injeksi(sk.1-0.5-1mg/hr selama 10 hr penunjang 0.5 mg/hr .im) • Dosis R/ awal 0.

3x a week .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.