Toxicology

Question 1

Iron Toxicity

Answer 1

Toxic Dose:
20-60mg/kg absorbable elemental iron is mild to moderate.
>60mg/kg severe
the absorbable elemental iron needs to be calculated

Toxicosis: iron is highly reactive and creates free radicals. Therefore, large amounts are directly toxic to cells. Most commonly the GIT, vascular, hepatic and heart affected first.

Four Stages:
0 - 6h = GIT upset e.g. ulceration etc.
6-24h = apparent recovery
12-96h = return of GIT signs plus metabolic acidosis, shock, hepatic failure, CVRS collapse, coagulopathies
2-6w = not common, but can have GIT obstruction from the fibrosis

Testing: serum iron and iron binding capacity. CBC, biochem etc.

Treatment:
Decontamination, supportive (fluids, gastroprotection, electrolyte management)
Chelating agents can be used if serum iron >300ug/dL