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PHARMACOKINETICS
A. Absorption
Duodenum and proximal jejunum
Excess iron can be stored in mucosal
cell as ferritin
B.Transport
Iron is transported in the plasma
bound to transferrin
PHARMACOKINETICS
C. Storage
Iron is stored, primarily as ferritin in
intestinal mucosalcells
macrophages in the liver
spleen, and bone
D. Elimination
feces, bile, sweat, urine, saliva
Duodenum
(average, 1 - 2 mg
per day)
Dietary iron
Utilization
Plasma
transferrin
(3 mg)
Muscle
(myoglobin)
(300 mg)
Liver
(1,000 mg)
Circulating
erythrocytes
(hemoglobin)
(1,800 mg)
Storage
iron
Bone
marrow
(300 mg)
Reticuloendothelial
macrophages
(600 mg)
Systemic Manifestations of
Iron Deficiency
Glossitis
Koilonychia
Angular chelitis
Normal RBC
Microcytic hypochromic
anemia
Hookworn infestation
Pregnancy
Malabsorption Syndrome
Premature Babies
Blood loss
GENERAL MECHANISM OF
ACTION OF IRON
SUPPLEMENT
During the process of absorption, oxygen
combines with iron and is transported into the
plasma portion of blood by binding to transferrin.
From there, iron and transferrin are used in the
production of hemoglobin (the molecule that
transports oxygen in the blood) and myoglobin
( helps your muscle cells store oxygen.)
Nausea
Epigastric discomfort
Abdominal cramps
Constipation and diarrhea.
Black stool
Indications
Malabsorption
Iron-limited response to erythropoietin
Toxicity/noncompliance with oral iron
Response
Maximal increase in hemoglobin
synthesis
Rapid increase in iron stores
TOXICITY OF IRON
Sign and symptoms:
- Acute: necrotizing gastroenteritis,
shock, metabolic acidosis, coma and
death
- Chronic: patients receive frequent
transfusions, hemochromatosis and
herited abnormality of iron
absorption
HEMATOPOIETIC
GROWTH FACTOR
1.
Erythropoietin
- Stimulate the production of red cell
- Used for anemias associated with renal failure
2. Myeloid growth factors
- Filgrastim (G-CSF) and sargramostim (GM-CSF)
neutrophils
- GM-CSF
myeloid and megakaryocyt
3. Megakaryocyt growth factors
- Oprelvekin and thrombopoietin
4. Other hematopoietic growth factors
- M-CSF, SCF and interleukins 3, 6, 9
SUMMARY
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