By

Noorul Alam.I

Pharmaceutical Products?
Pharmaceutical products
are suitable for treatment or prevention of
diseases in humans or animals,
or

can be used in or given to humans or animals to

restore, change or affect physiological functions by
means of a pharmacological, immunological or
metabolic effect, or to make a medical diagnosis.

Blood Products?

Blood products are the whole blood or its

components which are collected, processed and stored
which are suitable for treatment of diseases in humans
or animals.

Biopharmaceutical products purified from

human blood, such as the blood clotting factor VIII used
to treat haemophiliacs.

What is blood?
Blood is a connective tissue

Humans contain 5 liters on average

8% of body weight is blood

Functions of Blood
Transportation
Regulation
Protection

INTRODUCTION
1628 - William Harvey discovers the circulation of blood.
1665 - The first recorded successful blood transfusion
occurs in England: Physician Richard Lower keeps dog
alive by transfusing blood from other dogs.
1818 - British obstetrician James Blundell performs the
first successful transfusion of human blood to a patient for
the treatment of postpartum hemorrhage

Blood Group

by Landsteiner, 1901

1907 - Ludvig Hektoen suggests that the safety of

transfusion might be improved by cross-matching blood
between donors and patients to exclude incompatible
mixtures.
Reuben Ottenberg performs the first blood transfusion
using blood typing and cross-matching.
Sodium Citrate Hustin, 1915.

1st World War (19141918)

stimulus.

1939-1940 - The Rh blood group system is discovered by

Karl Landsteiner, Alexander Wiener, Philip Levine and R.E.
Stetson.

Whole Human Blood:

Whole Human Blood:

Blood with suitable anticoagulant.
Donor 1. Not suffering from transmitting disease due to blood
transfusion like syphilis, serum jaundice, etc.
2. Not anemic - Hb count not < 12.5 (females)
not < 13.3 (males)

Collection:
Collected - from Median cubital Vein.
- in a sterile container
containing anticoagulant.

contd

Gently shaken during Collection

Maximum of 420 ml is taken.
Then sealed and cooled to 4-6C

SINGLE_BLOOD_BAG_HOLDER

contd

Blood Clotting:
Classical Theory:
1. Prothrombin
2. Fibrinogen

Thromboplastin +
Ionized Calcium
Thrombin

Thrombin.

Fibrin

ANTICOAGULANTS:
1. Citrates:
Most commonly used Acid citrate Dextrose (ACD)
Composition:
Sodium acid citrate 2.0 to 2.5 G
Dextrose
- 3.0 G
WFI
- 120 ml
Mechanism: Calcium ion --------------- unionized calcium citrate.
Trisodium citrate was also used due to alkaline pH cause
caramellisation of dextrose during sterilization.
Dextrose delays haemolysis of erythrocytes (in vitro) & prolong their
life after trans fusion. Synthesis ATP

contd

2.Heparin:
Naturally occurring by mast cells.
Occasionally used during large transfusion. Eg: cardiac surgery.
As large amount of citrate is harmfull.
Expensive, needs neutralizing substance (protamine sulphate).

3.Disodium Edetate:
Chelates with Calcium divalent ion.
Used when preservation of blood platelets is essential.

Blood Groups:
ABO system

Antigen Aglutinogens
Antibody - Agglutinins

Rh system

contd

Subtypes is blood group:

A1 Negative (A1 -ve)

A2B Positive (A2B +ve)

A1 Positive (A1 +ve)

B Negative (B -ve)

A1B Negative (A1B -ve)

B Positive (B +ve)

A1B Positive (A1B +ve)

B1 Positive (B1 +ve)

A2 Negative (A2 -ve)

O Negative (O -ve)

A2 Positive (A2 +ve)

O Positive (O +ve)

A2B Negative (A2B -ve)

Storage:
Stored at 4-6C - Within half an
hour from collection.
Deleterious reaction s:
Leucocytes disintegrates within
few hours
Platelets disintegrates within
few hours
RBCs
shows fall in ATP
and other organic Phospates.
- reduction in oxygen carrying capacity.
- increased fragility due to lipid loss from the membrane.
Fitness of blood for transfusion based on its appearance.
Complete haemolysis sign of bacterial infection.
Pseudomonas and other members of coli-aerogenes survive at refrigerator temp.

Uses:
Used during
Loss of blood hemorrhage,.
Loss of vital constituents Shock,
Burns,
Uncontrolled Diarrhoea,
Vomitting,
Hemorrhage,etc.

Blood Products:
Blood

Plasma

Immunoglobin
(Gamma globulin)

RBC

Serum

Clotting
factor

Fibrinogen

Fibrin
(foam)

Thrombin

CONCENTRATED RBC:
Preparation - plasma
removed by centrifugation of
whole blood (not>fortnight
old).

Thorough
aseptic
precautions carried out.
Used within 12 hrs, Hb not < 15.5%
Cells matched with recipients plasma

Uses:
To treat chronic anaemia, (whole blood may overtax)
Exchange transfusions in infants.
Plasmapheresis

DRIED HUMAN PLASMA:

Disadvantage of whole blood: Advantage of plasma:
Short life (three weeks)

Five years if properly stored.

Can be stored at RT 20C (light
Need refrigeration
protected)
Should be compatible with recipient Given to recipient of any blood
group.
Used as substitute for whole blood.

Preparation:
Two major problems:
(A) transmission of Viral Jaundice:
1) Infective Jaundice
incubation period 5 weeks
2) Homologous serum Jaundice
incubation period 20 weeks.

contd

B) Neutralization of plasma agglutinins:

Occasionaly the plasma agglutinins cause haemolysis of
recipient cell.
ratio of mixing plasma from different groups. (cross
neutralizing)
9 of A : 9 of O : 2 of B : or AB
Preliminary freezing:
centrifuged at -18C
Preliminary Drying:
placed in drying chamber with high vacuum. Condensing coil at
-50C, small heater provide latent heat of evoporation. Duration -2 days
Secondary Drying:
dried by vacuum desiccation over phosphorous pentoxide.
Duration 1 day.

contd
Storage: At 20 C and protected from light , moisture, and Oxygen.

Expiry date 5 years

Fitness of which is shown by the solubility when reconstituted with
WFI, NaCl injection, or Solution contationing 2.5% of
dextrose, 0.45% NaCl , eqivalent to original volume of plasma.
- must dissolve in 10 mins at RT.

Labelling: Label should state,

1. Name and % of anticagulant and added substance.
2. WFI required
3. Protein content
4. content must be used within 3 hrs after reconstitution
Uses: Used as the alternative to the Whole blood
Treatment of Burns and scalds.
Restore blood volume ( Emergency)
In fibrinogen deficiency: dried plasma reconstituted to 1/3 rd or th of
original vol.
Dried residue of plasma ( 400ml) - 1 g fibrinogen.

FRESH FROZEN PLASMA:

Preparation:
Freshly collected blood - Centrifuged stored in frozen state (-30 C)
If it is not pooled shold be labelled and used according to stated blood
group.
During usage thawed (45 mins) not exceeding 37C

Use:
Labile clotting factors present
So source of factor VIII to treat minor haemorrhage

Fractionation of Plasma:
Protein seperation method salting out ( dialysis
required)
- Not suitable for plasma frationation
Cohnss technique use of organic solvent (Ethanol or Ether).
Advantages of organic solvent:

Volatility- so removed easily

Salt in low conc to improve resolution

Bactericidal activity

Being liquid easy to add aseptically.

Human Fibrinogen:

Ether 11 %
Plasma

Fibrinogen

0
C pH 7.7
Fibrinogen is the soluble constituent of plasma. With thrombin it forms as fibrin
Preparation

Fractionation of Plasma
Precipitate is collected by centrifugation
Dissolved in citrate-saline and freeze dried

Air in the container is removed by nitrogen.

Citrate prevents spontaneous clotting when reconstituted with saline

Fibrinogen dissolves slowly but froth badly, so agitation should be limited to rocking.
Must be used immediately after reconstitution (within 3 hrs).
USE: To treat fibrinogen deficiency. More often used along with Thrombin

Human Thrombin
Ether 11 %

Plasma

Fibrinogen
0
C pH 7.7

Ether 10 %
Supernatant 1

Prothrombin
0
C pH 5.35

Thrombin is the enzyme converts fibrinogen to fibrin

Prothrombin is obtained by fractionation and washed with water.

Dissolved in citrate saline.

It is converted to thrombin by

Adjusting the pH to 7 and

Adding Thromboplastin and calcium citrate.
Solution is filtered and Freeze dried.

Air in container is replaced with nitrogen.

USE:
* Fibrinogen + thrombin = Fibrin

* Fibrin used in surgery to suture severed nerves

* Assist adhesion of skin graft.

* As Haemostat..
Human Fibrin Foam:
It is a sponge like mass of human fibrin.
Preparation:
Whipping a solution of fibrinogen into a froth by mechanical means
Thrombin is added to it.

It forms fibrin clot.

Product is poured into tray and freeze dried, Then cut into pieces
Sterilized by Dry Heat at 130 C for 3 hrs.

Use:
Haemostat in surgery. (A piece is dipped into thrombin and applied
to the bleeding area)

Foam can be left in situ

Human Normal Immunoglobulin Injection:
Ether 11 %
Plasma

Fibrinogen

0
C pH 7.7
Ether 10 %
Supernatant 1

Prothrombin

0
C pH 5.35

Ether 18.5 %
Supernatant 2

Globulin
-3.5
C pH 5.5
Ionic Conc. 0.035
Ether 9 %

Globulin

Beta Globulin
0
C pH 5
Ionic Conc. 0.01

Ether 18.5 %
Supernatant

Gamma Globulin
-3.5
C pH 6.75
Ionic Conc. 0.025

Ionic strengths are critical

Immunoglobulins are dissolved in suitable solvent (0.8% Na Cl)

Preservative is added to it.(0.01% thiomersol)

Sterilized by filtration
Packed in single dose container
Stored at 4 to 6 C with protection from light.

Pool of NLT 1500 donation used to get various type of antibodies

Antivaccina and antitetanus immunoglobulins obtained from recently

immunized donors
USE:
To prevent or attenuate Measles, Rubella and infectious Hepatitis.

Hypogammaglobulinaemia
Patient susceptible to bacterial infection (Gram +ve)

PLASMA SUBSTITUTES
Properties of an Ideal Plasma Substitute.
1.Same colloidal pressure as whole blood.
2.Viscosity similar to plasma.
3. Molecule do not easily diffuse through the capillary wall (. Molecular wt)
4. Low rate of excretion or destruction by the blood.

5. Complete elimination from the body.

6. Freedom from toxicity (No renal impairment)
7. Freedom from antigenecity, Pyrogenecity .
8. Isotonicity.
9. Highly stable in liquid form at normal condition and sterilization, transport

and storage.
10. Ease of preparation, ready availability and low cost.

Gum Saline (offficial I BP- 1932)

- Injection of sodium chloride and Acacia
- 6% Acacia in 0.9 % NaCl solution.

- Not metobolised but stored in different organs.

Polyvinylpyrolidone

- Synthetic colloid, For treatment of shock.

- Susceptible for Carcinogenicity. (in 1950 s withdrawn)
DEXTRAN
Polysaccharide produced by
Leuconostoc mesenteroides (Bacterium)

dextran-sucrase
n sucrose

n(glucose H2O) + Fructose

(used by organisms)

Natural Dextran
consists of approximately 200 000 glucose unit (Mol. Wt 5 million)

Drawbacks with Mol. Wt > 250 000:

Viscous solution difficult to administer.

Cause Renal damage & allergic Xns

Interfere with blood matching and sedimentation tests by causing
rouleaux formation.

So Size reduced by
1. Acid Hydrolysis ( Adjusted to pH 2 and heated to 90 C)

2. Thermal degradation
Heated at 160 C, under pressure.
In presence of
Sodium sulphite prevent oxidative degradation
Calcium carbonate neutralise acidity

3. Ultrasonic disintegration
4. seeding the fermenter

Drawbacks with Mol. Wt < 60 000:

Rapidly excreated in urine

Pass into tissue fluids causing an adverse osmotic pressure

Mol. Wt : 60 000 100 000

60 000
Rreadily
excreted in
urine
Lost into
tissue fluids

100 000
Lost into tissue
fluids

250 000

Acceptable range

Causes allergy
and renal
damage
Interfere with
tests

DEXTRAN 110 Injection

- Solution of the polymer in Dextrose Injection 5 g/l, or in Sodium
Chloride Injection

- Sterilized either by autoclaving or filtration.

- Dextran 110 Injection in 5 g/l dextrose Store Below 25 - 5 Years

- Dextran 110 Injection in NaCl Injection Store Up to 40 - 5 Years.

- Emergency restoration of blood volume.
Dextran 40 Injection
- Avg. molecular weight of 40,000

- Small molecular weight dextran of this size has a specific action

in diminishing red cell aggregation
- Below 25 - 5 Years
- Method of preparation is similar to Dextran 110.

Questions
please