What is the antidote for iron overload?

Appeared in: Punjab CHO - 2021

Explanation

Deferoxamine is a specific chelating agent with a high affinity for iron.
It binds to free iron in the blood, forming a stable, water-soluble complex (ferrioxamine).
This complex is then excreted by the kidneys, effectively removing excess iron from the body.
It is considered the parenteral chelator of choice for treating both acute and chronic iron overload.

Option B: Glucose is a simple sugar used to treat hypoglycemia (low blood sugar); it has no chelating properties and does not counteract the effects of iron poisoning.
Option C: While Dimercaprol is a chelating agent, it is specifically contraindicated for iron poisoning because the dimercaprol-iron complex is itself toxic, particularly to the kidneys.
Option D: Activated charcoal works by adsorbing toxins in the gastrointestinal tract, but it does not effectively bind to metals or ions like iron.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology: Antidotes and Chelation Therapy as background academic context rather than a clinical decision trigger.
A key nursing responsibility during Deferoxamine infusion is to monitor for hypotension, which can occur with rapid administration. The infusion rate must be carefully controlled.
The characteristic 'vin-rose' (reddish-orange) color of the urine is an expected finding that indicates the drug is effectively binding and excreting iron. Its absence may suggest a need to re-evaluate therapy.
For patients on long-term therapy (e.g., for thalassemia), nurses must educate the patient and family about the need for regular auditory and visual check-ups due to the risk of sensory toxicity.

How to Approach the Question

Identify the core of the question: it asks for a specific antidote for a specific substance (iron). This is a factual recall question.
Analyze the substance: Iron is a heavy metal. Recall that heavy metal poisoning is often treated with chelating agents.
Evaluate the options based on their primary pharmacological action.
Eliminate Glucose, as it is a sugar used for hypoglycemia, not poisoning.
Eliminate Activated Charcoal, as it is known to be ineffective for binding metals.
Differentiate between the two chelating agents. Deferoxamine is the specific agent for iron, while Dimercaprol is used for other metals and is contraindicated for iron. This leads to the correct answer.

Concept Tested & Keywords

QmtCyibSKDqac3YQ2hLWeT

E6 Pharmacology Katzung 16e p. 1604-1606

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 776-778

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