Intoxication iron preparations
Contents:
Description:
Acute poisoning with iron preparations is observed rather seldom; in connection with increase in popularity of the drugs containing iron (for example, polyvitamins with microelements, etc.), the frequency of poisoning increased. Frequency. In 1988 in the USA over 16 000 cases of intoxication were registered by ferriferous drugs. The prevailing age — children's (in 1984 1 337 cases of poisoning with iron preparations from 1 738 6 years were registered among children more young).
Intoxication symptoms iron preparations:
Nausea, vomiting, diarrhea, drowsiness, pains in upper parts of a stomach, pallor, perspiration. In hard cases — cyanosis, vomiting with blood, a coagulopathy, acidosis, disturbance of microcirculation before development of shock and a coma. The first acute symptoms are often followed by a light interval (the seeming recovery). In 12–48 h symptoms can recur, in hard cases deep shock, heavy acidosis, cyanosis, a hyperthermia, a convulsive syndrome, an anury develops; the fluid lungs, a lethal outcome are possible. In the remote period (2–6 weeks) the stenosis in peloric or antral department of a stomach develops, cirrhosis and irreversible disturbances of TsNS are possible.
Laboratory researches: OAK, determination of content of electrolytes and glucose in blood, definition of concentration of iron in blood serum, and also OZhSS, definition of a ratio of PV/MSS (PV / the international standardized ratio) and ChTV, at a serious poisoning — functional trials of a liver.
Special researches — a X-ray analysis of abdominal organs and a thorax.
Intoxication reasons iron preparations:
Intoxication develops at oral administration of pure iron in a dose more than 60 mg/kg. A dose, deadly to the person — 200–250 mg/kg of pure iron (for 2-year-old children a lethal dose of pure iron — 3 g).
Risk factor — free access of children to iron preparations and ferriferous vitamins.
Treatment of Intoxication iron preparations:
Maintaining tactics: At a serious poisoning — hospitalization. Vomitives, a gastric lavage via the probe carry out if the amount of the pure iron accepted by the patient exceeds 20 mg/kg, in the presence of characteristic symptoms. Specific (antidotal) therapy. At reception of a lethal dose of iron preparations — a hemodialysis, peritoneal dialysis, exchange hemotransfusions. Symptomatic therapy.
Specific (antidotal) therapy. At the content of iron in plasma more than 300 mg of % — Deferoxaminum of 1 g in/in kapelno (with a speed up to 15 mg/kg/h) for the term of no more than 24 h or 1–2 in oil each 3–12 h (under control of color of urine: during 2 h urine gains red color; if discoloration does not occur, injections stop). Concentration of iron in blood serum of the patient against the background of the specified therapy usually decreases during 12–48 h.
The current and the forecast depend on amount of the accepted drug and duration of its impact on an organism.
