Farmakologi: Obat-Obat Anemia
Farmakologi: Obat-Obat Anemia
Farmakologi: Obat-Obat Anemia
OBAT-OBAT ANEMIA
Oleh
Valentina Meta Srikartika, S. Farm, Apt
Definisi
Definisi
Sekelompok gangguan yang dikarakterisasi
dengan penurunan Hemoglobin atau Sel
Darah Merah, berakibat pada penurunan
kapasitas pengangkutan oksigen oleh darah
Klasifikasi
Klasifikasi
Morfologi
Anemia Makrositik
• Anemia Megaloblastik
1. Defisiensi Vitamin B12
2. Anemia defisinsi Asam Folat
Anemia Mikrositik, Hipokromik
• Anemia defisiensi besi
• Anomali genetik
1. Sikle cell anemia
2. Thalasemia
3. Hemoglobinopati lainnya (hemoglobin normal)
Anemia Normositik
• Kehilangan darah
• Hemolisis
• Kegagalan sumsum tulang
• Anemia penyakit kronis
• Gagal ginjal
• Kelainan endokrin
• Anemia mieloplastik
Klasifikasi
Klasifikasi
Etiologi
Defisiensi
• Besi
• Vitamin B 12
• Asam Folat
• Piridoksin
Pusat, disebabkan gangguan sumsum tulang
• Anemia penyakit kronis
• Anemia pada lansia
• Kanker sumsum tulang
Periferal
• Pendarahan (hemmorhage)
• Hemolisis (anemia hemolitik)
Klasifikasi
Klasifikasi
Patofisiologi
Kehilangan Darah Berlebihan
Pendarahan Kronis
Destruksi sel darah merah berlebihan
Faktor Intrakorpuskular
Produksi SDM dewasa tidak cukup
Anemia
AnemiaMakrositik
Makrositik
Causes :
•Vitamin B 12
deficiency ( Anemia
Pernisiosa )
•Folate deficiency
Anemia
AnemiaPernisiosa
Pernisiosa
It can Happen If :
• In this anemia, your body destroys the cells in your stomach
that help you absorb vitamin B12.
• You have had surgery to remove part of the stomach or the
last part of your small intestine, called the ileum . This includes
some types of surgery used to help very overweight people
lose weight.
• You have problems with the way your body digests food, such
as sprue (also called celiac disease), Crohn's disease, bacteria
growth in the small intestine, or a parasite.
• You take medicine for heartburn and ulcers for a long time.
Anemia Defisiensi As. Folat
Anemia Defisiensi As. Folat
It can Happen If :
• You don't eat enough foods that contain folic acid.
These include citrus fruits, leafy green vegetables, and
cereals.
• You have a greater need for folic acid. This might
happen if you are pregnant.
• Your body doesn't absorb enough folic acid. This might
happen if you drink too much alcohol or have severe
kidney problems that require blood-cleaning procedures.
• You take certain medicines, such as some used for
cancer, rheumatoid arthritis, and seizures
Anemia
AnemiaMikrositik
Mikrositik
Causes :
Iron Deficiency
Thallasemia
Sickle cell anemia
Anemia
AnemiaDefisiensi
DefisiensiZat
ZatBesi
Besi
It can Happen If:
• Have heavy menstrual bleeding.
• Are not getting enough iron in food. This can happen in
people who need a lot of iron, such as small children, teens,
and pregnant women.
• Have bleeding inside your body. This bleeding may be caused
by problems such as ulcers, hemorrhoids, or cancer. This
bleeding can also happen with regular aspirin use. Bleeding
inside the body is the most common cause of iron deficiency
anemia in men and in women after menopause.
• Cannot absorb iron well in your body. This problem may
occur if you have celiac disease or if you have had part of your
stomach or small intestine removed.
Anemia
AnemiaPenyakit
PenyakitKronis
Kronis
Anemia of chronic disease, increasingly referred to
as "anemia of inflammation", is a form of anemia
seen in chronic illness,e.g. from chronic infection,
chronic immune activation, or malignancy. New
discoveries suggest that the syndrome is likely
largely the result of the body's production of
hepcidin, a master regulator of
human iron metabolism.
Anemia
Anemiain
inCKD
CKD
Why do people with kidney disease get anemia?
Your kidneys make an important hormone called
erythropoietin (EPO). Hormones are secretions
that your body makes to help your body work and
keep you healthy. EPO tells your body to make red
blood cells. When you have kidney disease, your
kidneys cannot make enough EPO. This
causes your red blood cell count to drop
and anemia to develop.
Anemia
Anemiain
inCKD
CKD
Manifestasi
ManifestasiKlinis
Klinis
Sign and Symptom
Anemia Onset Akut
Gejala kardiorespiratory (tachycardia, lightheadedness, and
Breathlessness)
Anemia Kronis
weakness, fatigue,
headache, vertigo, faintness, cold sensitivity, pallor, and loss of
skin tone.
Anemia Defisiensi Besi
glossal pain, smooth tongue, reduced salivary flow, and
pagophagia (compulsive eating of ice). These symptoms are not
usually seen until the Hb concentration is less than 9 g/dL.
Anemia Defisiensi Vitamin B12
pallor, icterus (jaundice) and gastric mucosal atrophy. Vitamin B
12 anemia is distinguished by neuropsychiatric abnormalities
(e.g., numbness, paresthesias, irritability), which are absent in
patients with folate-deficiency anemia.
Icterus
Icterus(Jaundice)
(Jaundice)
Normal
NormalHematologic
HematologicValue
Value
Terapi
Terapi: :Produk
Produkyang
yangmengandung
mengandungBesi
Besi
Terapi
Terapi: :Produk
Produkyang
yangmengandung
mengandungBesi
Besi
Terapi
Terapi: :Produk
Produkyang
yangmengandung
mengandungBesi
Besi
Terapi
Terapi: :Produk
ProdukVitamin
VitaminB12
B12
Mekanisme Kerja :
Vitamin B12 penting untuk pertumbuhan,
reproduksi sel, hematopoiesis, dan sintesis
nukleoprotein dan mielin. Vitamin B12 berperan
dalam pembentukan sel darah merah melalui
aktivitas koenzim asam folat
Indikasi :
Anemia Pernisiosa, Peningkatan kebutuhan vitamin
B12
Terapi
Terapi: :Produk
Produk Asam
AsamFolat
Folat
Mekanisme Kerja :
Folat eksogen dibutuhkan untuk sintesis
nukleoprotein dan pemeliharaan eritropoiesis
normal. Asam folat menstimulasi produksi sel
darah merah, sel darah putih, dan platelet pada
anemia megaloblastik
Indikasi :
Anemia Pernisiosa dan anemia megaloblastik
Terapi
Terapi: :Produk
Produk Epoetin
EpoetinAlfa
Alfa
Mekanisme Kerja :
Menstimulasi eritropoiesis pada pasien anemia
yang sedang menjalani dialisis
Indikasi :
• Pengobatan anemia berkaitan dengan gagal ginjal
kronis
• Pengobatan anemia yang berkaitan dengan terapi
zidovudin pada pasien yang terinfeksi HIV
• Pengobatan anemia pada pasien kanker yang
mengalami kemoterapi
• Penurunan transfusi darah allogenik pada pasien
yang dioperasi