Acute Iron Poisoning

| Home | | Pharmacology |

Chapter: Essential pharmacology : Drugs Affecting Blood And Blood Formation

It occurs mostly in infants and children: 10–20 iron tablets or equivalent of the liquid preparation (> 60 mg/kg iron) may cause serious toxicity in them. It is very rare in adults.


ACUTE IRON POISONING

 

It occurs mostly in infants and children: 10–20 iron tablets or equivalent of the liquid preparation (> 60 mg/kg iron) may cause serious toxicity in them. It is very rare in adults.

 

Manifestations are vomiting, abdominal pain, haematemesis, diarrhoea, lethargy, cyanosis, dehydration, acidosis, convulsions; finally shock, cardiovascular collapse and death. In few cases death occurs early (within 6 hours), but is typically delayed to 12– 36 hours, with apparent improvement in the intervening period. The pathological lesion is haemorrhage and inflammation in the gut, hepatic necrosis and brain damage.

 

Treatment

It should be prompt.

 

To Prevent Further Absorption Of Iron From Gut

 

·      Induce vomiting or perform gastric lavage with sodium bicarbonate solution—to render iron insoluble.

·      Give egg yolk and milk orally: to complex iron. Activated charcoal does not adsorb iron.

 

To Bind And Remove Iron Already Absorbed

 

Desferrioxamine (an iron chelating agent—see Ch. No. 66) is the drug of choice. It should be injected i.m. (preferably) 0.5–1 g (50 mg/kg) repeated 4–12 hourly as required, or i.v. (if shock is present) 10–15 mg/kg/hour; max 75 mg/kg in a day till serum iron falls below 300 μg/dl. Early therapy with desferrioxamine has drastically reduced mortality of iron poisoning.

 

Alternatively DTPA or calcium edetate (see Ch. No. 66) may be used if desferrioxamine is not available. BAL is contraindicated because its iron chelate is also toxic.

 

Supportive Measures

 

Fluid and electrolyte balance should be maintained and acidosis corrected by appropriate i.v. infusion. Respiration and BP may need support. Diazepam i.v. should be cautiously used to control convulsions, if they occur.

 

Contact Us, Privacy Policy, Terms and Compliant, DMCA Policy and Compliant

TH 2019 - 2022 pharmacy180.com; Developed by Therithal info.