What is the antidote for iron overdose?

Appeared in: Bihar CHO -2019

Explanation

Deferoxamine is the specific chelating agent used to treat moderate to severe iron poisoning.
It works by binding to free ferric iron in the bloodstream, forming a stable, water-soluble complex called ferrioxamine.
This ferrioxamine complex is then excreted by the kidneys, which often causes the urine to turn a characteristic reddish-brown or pink color, known as 'vin-rosé' urine.
Chelation therapy is indicated in cases of systemic toxicity, such as shock, severe acidosis, or significantly elevated serum iron levels (e.g., greater than 5 mg/L).

Option A: Naloxone is an opioid antagonist and has no effect on iron.
Option C: Physostigmine is a cholinesterase inhibitor and is not used for metal poisoning.
Option D: This option is incorrect because a specific antidote, Deferoxamine, exists for iron overdose.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology: Antidotes for Specific Poisonings as background academic context rather than a clinical decision trigger.
Nurses must be able to rapidly identify signs of severe iron toxicity (shock, acidosis, altered mental status) to initiate chelation therapy promptly, as delays can lead to irreversible organ damage.
Monitoring urine color is a critical, non-invasive nursing assessment to gauge the effectiveness of Deferoxamine therapy. The absence or disappearance of the 'vin-rosé' color may indicate that most of the free iron has been chelated.
It is crucial to remember that activated charcoal is ineffective for iron poisoning. A nurse advocating for this would be incorrect; the correct initial decontamination strategy might be whole bowel irrigation.

How to Approach the Question

Identify the core of the question: It asks for the specific antidote for 'iron overdose'.
This is a direct recall question from pharmacology. Access your knowledge of common toxins and their specific antidotes.
Evaluate each option:
Naloxone: Recall this is for opioids.
Deferoxamine: Recall this is a chelating agent. It is known to bind iron.
Physostigmine: Recall this is for anticholinergic syndrome.

Concept Tested & Keywords

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E6 Medicine Davidson Principles Practice 24e p. 160-162

E6 Pharmacology Katzung 16e p. 1604-1606

Practise the full Bihar CHO -2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.