Pharmacology MCQ 489 Answer

The Correct option is E

Management of Iron overdose:

1. Decontamination: Iron is well known to form drug concretions (pharmacobezoar) and/or become adherent to the gastric wall due to its corrosive effect. Activated charcoal is not effective.

• whole bowel irrigation
• gastroscopic removal
• gastrotomy
  

X-ray review following decontamination procedures should be performed to ensure removal of drug from the GIT.

2. Antidote: Desferrioxamine , 15mg/kg/hour - up to 80mg/kg/day in first day…

Continue treatment until serum iron ≤ 60 mcmol/l, patient asymptomatic and urine colour is no longer “vin rosé” (ensure no iron remains in the gut).

Note:

• hypotension following rapid infusion (?anaphylactoid reaction)
• renal failure occur if patient hypovolaemic
• prolonged (greater than 24 hour) infusions associated with ARDS
• interference with serum iron measurement (spurious reduction)
• pre-disposes patient to Yersinia enterocolitica infection

3. Supportive care:

1. aggressive fluid replacement
2. correction of acidosis (sodium bicarbonate)
3. correction of coagulation disorders (fresh frozen plasma)

Category: Pharmacology MCQs