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26 Cards in this Set
- Front
- Back
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recommended iron intake for boys, adult men and nonmensturating women?
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8mg
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recommended iron intake for menstuating women?
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18mg
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recommended iron intake for preggos
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27mg
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unbound iron, or free iron, does not exist within the body and essentially all circulating plasma iron is normally bound to?
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Transferrin
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by what mechanism does iron act as a direct Gi tract irritant and cause vomiting, diarrhea, abd pain, mucosal ulceration and bleeding soon after significant ingestion?
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Iron is a potent catalyst for the production of oxidants such as FREE RADICALS
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what kind of Acid Base disturbance is seen with iron tox
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Metabolic acidosis
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Moderate toxicity with iron poisoning occurs at what dose?
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20-60 mg/kg of elemental iron
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Severe toxicity with iron poisoning occurs at what dose?
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>60mg/kg elemental iron
note: the most common formulation has 65mg of elemental iron and 20-35 tablets would be expected to produce moderate tox in acute ingestion in adults |
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how many tablets of iron would you expect to cause moderate tox in an adult?
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20-35 tablets would be expected to produce moderate tox in acute ingestion in adults
the most common formulation has 65mg 20-60 mg/kg of elemental iron |
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What are the two clinical stages of iron tox?
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Local GI tract tox
Systemic tox |
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Give a brief summary of the 5 stages of iron toxicity?
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Stage 1: abdominal pain, n/v (GI sx in first 6 hours)
Stage 2: "latent" GI sx resolve and falsely reassure, volume loss and worsening met acid occur Stage 3: Systemic tox, shock and lactic acidosis, coagulopathy (bleeding), renal failure, cardiomyopathy Stage 4: Hepatic stage, 2-5 days, elevated ALT, possible failure Stage 5: delayed sequelae, including gastric outlet obstruction |
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clinical sign MOST consistently assoc with acute iron tox?
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vomiting
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given the following description, give the stage of iron tox:
abdominal pain, n/v (GI sx in first 6 hours) |
Stage 1:
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given the following description, give the stage of iron tox:
"latent" GI sx resolve and falsely reassure, volume loss and worsening met acid occur |
Stage 2
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given the following description, give the stage of iron tox:
Systemic tox, shock and lactic acidosis, coagulopathy (bleeding), renal failure, cardiomyopathy |
Stage 3
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given the following description, give the stage of iron tox:
Hepatic stage, 2-5 days, elevated ALT, possible failure |
Stage 4
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given the following description, give the stage of iron tox:
delayed sequelae, including gastric outlet obstruction |
Stage 5
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T/F
iron levels measured within 4-6 hours after an acute ingestion correlate with the severity of toxicity, but low serum iron levels DO NOT NECESSARILY mean absence of toxicity |
true
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T/F
Serum total iron binding capacity has little value in the assessment of iron poisoned pts |
true
it becomes falsely elevated in the presence of elevated serum iron |
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T/F
Activated charcoal should be used in iron tox |
False
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what should be done for an unknown amount ingested of iron?
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consider abdominal radiograph
consider GI decontamination (orogastric lavage, whole bowel irrgation with polyethylene glycol solution) obtain 4 hour post ingestion serum Fe |
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if an unknown amount is ingested, or if a pt has GI sx alone, at what time frame do you want your serum Fe?
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4 hour post ingestion
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DOC for iron tox?
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Deferoxamine
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at what measured serum Fe should you initiate deferoxamine tx?
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>500 micrograms/dL
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Recommended initial deferoxamine dose?
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1000mg IV
start at 5mg/kg/hr |
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recommended amount of deferoxamine for an acute iron overdose is a total of?
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360mg/kg or 6 grams during the first 25 hours
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