FARMAKOLOGI

OBAT-OBAT ANEMIA
Oleh
Valentina Meta Srikartika, S.
Farm, Apt

Definisi
Sekelompok gangguan yang
dikarakterisasi dengan penurunan
Hemoglobin atau Sel Darah Merah,
berakibat pada penurunan kapasitas
pengangkutan oksigen oleh darah

Normal Hematologic
Value

WHO's Hemoglobin thresholds used to

define anemia

Regulation of RBC
production

Life cycle
of red
blood
cells

Symptoms of Anemia

Erythrocyte parameters MCH, MCV and

MCHC

Klasifikasi (Production vs.

destruction or loss )

Klasifikasi (Red blood cell

size)

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
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
Patofisiologi

Kehilangan Darah Berlebihan

Pendarahan Kronis
Destruksi sel darah merah berlebihan
Faktor Intrakorpuskular
Produksi SDM dewasa tidak cukup

Anemia Makrositik

Cause
s:
Vitamin B 12
deficiency
( Anemia
Pernisiosa )
Folate
deficiency

Anemia 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
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 Mikrositik

Causes :
Iron Deficiency
Thallasemia
Sickle cell anemia

Anemia Defisiensi Zat

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 Penyakit 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.

Anemia in 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 in CKD

Manifestasi 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

Icterus (Jaundice)

Terapi : Produk yang mengandung

Besi

Terapi : Produk yang mengandung

Besi

Terapi : Produk yang mengandung

Besi

Terapi : Produk Vitamin 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 : Produk Vitamin B12

Terapi : Produk Asam 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 : Produk Asam Folat

Terapi : Produk Epoetin 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