Question

A child presents to the emergency department with a history of ingestion of 10-20 ferrous sulphate tablets. Arterial blood gas revealed acidosis. Which of the following can be used in the management of this condition? 

• A. Deferoxamine
• B. Activated charcoal
• C. Dimercaprol
• D. Penicillamine

Answer 1

The Correct Option is A

When a child ingests a significant amount of iron, typically found in ferrous sulfate tablets, it can lead to acute iron poisoning. This condition often results in gastrointestinal symptoms and can advance to systemic toxicity, which is reflected by metabolic acidosis as shown in arterial blood gas results.

The appropriate management for acute iron poisoning is the administration of a chelating agent, which binds free iron in the bloodstream, allowing it to be excreted from the body, thus reducing its toxic effects.

In this scenario, the correct option for the management of the child's condition is:

Deferoxamine: This chelating agent specifically binds to iron, forming a complex that can be excreted via the kidneys, thereby reducing free iron concentration in the blood and mitigating the effects of iron toxicity.

Other options like Activated charcoal, Dimercaprol, and Penicillamine are not suitable for this condition:

• Activated charcoal: It is not effective for iron overdose because it does not adsorb metals effectively.
• Dimercaprol: Primarily used for arsenic, gold, and mercury poisoning, not iron.
• Penicillamine: More applicable for copper toxicity (e.g., Wilson's disease) and not used for acute iron ingestion.

Therefore, Deferoxamine is the treatment of choice in this setting, ensuring removal of excess iron to prevent further damage from toxicity.