red blood cells(Blood component)

Action and Spectrum

Actions and Spectrum: 

red blood cells (RBCs), also known as erythrocytes, play a vital role in the circulatory system by transporting oxygen from the lungs to tissues and removing carbon dioxide.  

Oxygen Transport: 

• red blood cells’ main function is to carry oxygen from the lungs to the rest of the body and to facilitate the exchange of oxygen and carbon dioxide in tissues. 
• The key molecule in RBCs responsible for oxygen transport is hemoglobin. Hemoglobin binds to oxygen in the lungs and releases it in tissues where oxygen is needed. 

Carbon Dioxide Transport: 

• red blood cells also play a role in transporting carbon dioxide, a waste product of metabolism, from tissues back to the lungs for exhalation. 
• Carbon dioxide reacts with water in the blood to form bicarbonate ions, which are transported back to the lungs in the plasma. This process helps maintain the body’s acid-base balance. 

Flexibility and Deformability: 

• red blood cells are flexible and deformable, allowing them to squeeze through narrow capillaries and navigate the circulatory system’s intricate network. 

Lack of Immunological Components:  

• red blood cells do not have a nucleus or organelles, including those involved in immune responses. As a result, they lack immunological functions and do not have a spectrum of activity against pathogens. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Febrile Non-Hemolytic Reactions 

Septic Reactions 

Circulatory Overload 

Postransfusion Purpura 

Hemolytic Transfusion Reactions 

Allergic Reactions  

Transfusion Related Acute Lung Injury (TRALI) 

Transfusion Associated Graft Versus Host Disease 

Black Box Warning

Black box warning: 

None 

Contraindication / Caution

Contraindications/caution: 

Contraindications: 

• Hemolytic Reactions: If a patient has a history of a severe hemolytic transfusion reaction (an immune response leading to the destruction of transfused red blood cells), transfusion may be contraindicated. 
• Transfusion-Related Acute Lung Injury (TRALI): Individuals who have experienced TRALI in response to a previous transfusion may be at risk for a recurrence, and transfusion may be contraindicated. 
• Iron Overload: Conditions that lead to excessive iron accumulation in the body, such as hemochromatosis, may be a contraindication to RBC transfusion unless iron-chelating therapy is initiated. 
• Hypervolemia or Fluid Overload: In patients with CHF or other conditions causing fluid overload, transfusion may exacerbate fluid retention and lead to cardiac complications. 
• Acute Hemorrhage: In some cases of acute bleeding, particularly when rapid volume expansion is required, red blood cell transfusion may be contraindicated due to the potential for fluid overload. 
• Incompatible Blood Type: Transfusion of blood with an incompatible ABO blood type can lead to severe hemolytic reactions and is an absolute contraindication. 
• Transfusion Reaction History: Individuals who have a history of severe adverse reactions to blood transfusions may be at increased risk for future reactions and may be considered for alternative treatments. 

Caution: 

• Citrate Toxicity: Monitor for symptoms of citrate toxicity, such as muscle spasms or cardiac arrhythmias. 
• Acute Lung Injury (TRALI): Watch for sudden respiratory distress, a rare but severe reaction. 
• Hyperkalemia: Be cautious about potassium levels in massive or rapid transfusions, especially in patients with impaired kidney function. 
• Immunosuppression: Take special precautions to avoid transmitting infections in immunocompromised individuals. 
• Delayed Hemolytic Reactions: Be aware of the risk of developing antibodies against donor red blood cell antigens after repeated transfusions. 
• Transfusion-Associated Circulatory Overload (TACO):  Monitor for signs of respiratory distress due to volume overload, especially in patients with compromised cardiovascular status. 
• Hypothermia: Transfused blood is stored at cold temperatures, and rapid infusion can lead to hypothermia. Warming methods may be employed to prevent this. 

Pregnancy / Lactation

Pregnancy consideration: In pregnant women who are Cytomegalovirus-negative or whose Cytomegalovirus status is unknown, Cytomegalovirus-negative or Cytomegalovirus reduced risk (leukocyte decreased) RBCs should be used. 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

• Oxygen Transport: The primary function of red blood cells is to carry oxygen from the lungs to the tissues and organs. Hemoglobin, a protein contained within red blood cells, binds to oxygen in the lungs and releases it in peripheral tissues. 
• Carbon Dioxide Transport: red blood cells also play a role in transporting carbon dioxide, a waste product of metabolism, from tissues back to the lungs for exhalation. Carbon dioxide reacts with water in the blood to form bicarbonate ions, contributing to the regulation of acid-base balance. 
• Flexibility and Deformability: red blood cells are flexible and deformable, allowing them to squeeze through narrow capillaries and navigate the circulatory system’s intricate network. 
• No Metabolic or Synthetic Activity: red blood cells lack a nucleus and other organelles, which means they do not have the machinery for cellular metabolism or synthesis of proteins, enzymes, or other substances. 
• Lifespan and Clearance: red blood cells have a finite lifespan (approximately 120 days in circulation) before being removed by the spleen and liver. 
• Transfusion Therapy: red blood cell transfusions are a common therapeutic intervention for treating anemia or acute blood loss. 

Pharmacokinetics: 

Distribution 

red blood cells are distributed throughout the circulatory system, traveling in the blood vessels to deliver oxygen from the lungs to various tissues and organs. 

Metabolism 

Unlike many cells in the body, red blood cells lack a nucleus and mitochondria. They generate energy through anaerobic metabolism, mainly the Embden-Meyerhof pathway. 

Elimination and Excretion 

The spleen and liver remove aged or damaged red blood cells from circulation. This process is part of the body’s natural mechanisms for clearing senescent cells. 

Adminstartion

Administration: 

Intravenous administration 

The transfusion is typically administered through an intravenous (IV) line. A nurse or trained healthcare provider initiates the transfusion, allowing the red blood cells to flow into the patient’s bloodstream. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: red blood cells (Blood component) 

Why do we use red blood cells(Blood component)? 

red blood cells (RBCs), also known as erythrocytes, play a crucial role in the human body by transporting oxygen from the lungs to tissues and organs and facilitating the exchange of oxygen and carbon dioxide. The main uses of red blood cells are related to their oxygen-carrying function and their role in maintaining physiological balance. Here are the primary uses of red blood cells: 

• Oxygen Transport: red blood cells’ primary function is to transport oxygen from the lungs, where it is inhaled, to various tissues and organs throughout the body. 
• Carbon Dioxide Transport: red blood cells also assist in the transport of carbon dioxide, a waste product of cellular metabolism, from tissues back to the lungs for exhalation. 
• Maintaining Acid-Base Balance: red blood cells contribute to the regulation of the body’s acid-base balance by assisting in the conversion of carbon dioxide to bicarbonate ions, which helps maintain proper pH levels in the blood. 
• Tissue Oxygenation: Oxygen delivered by red blood cells is essential for the energy production in cells through cellular respiration. Adequate oxygenation supports the functioning of tissues and organs. 
• Hemoglobin Buffering: Hemoglobin, the protein within red blood cells that binds to oxygen, acts as a buffer, helping to stabilize the pH of the blood by binding to and releasing hydrogen ions. 
• Circulatory System Function: red blood cells contribute to the viscosity of blood, allowing it to flow smoothly through the circulatory system. Their biconcave shape enhances flexibility, facilitating passage through narrow capillaries.