Which medication is used to treat iron toxicity?

Appeared in: DHS Staff Nurse - 2018 (Shift-2nd)

Explanation

Deferoxamine (Desferal) is a chelating agent that specifically and avidly binds to iron.
It is the parenteral chelator of choice for treating both acute iron poisoning and chronic iron overload (e.g., from multiple blood transfusions in conditions like thalassemia).
Deferoxamine forms a stable complex with iron (ferrioxamine) that is water-soluble and excreted by the kidneys.
A classic sign of effective treatment is the appearance of reddish-brown urine, often called 'vin rosé' urine, due to the excretion of the iron complex.

Option A: Narcan (naloxone) is an opioid antagonist.
Option B: Digibind (digoxin immune Fab) is an antibody fragment that binds to digoxin.
Option D: Zinecard (dexrazoxane) is a cardioprotective agent.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology: Antidotes for Poisoning/Toxicity as background academic context rather than a clinical decision trigger.
Recognizing the signs of iron poisoning (e.g., in a child who has ingested iron supplements) and knowing the correct antidote is a critical nursing responsibility.
The nurse's role includes administering deferoxamine via slow IV infusion to prevent hypotension, monitoring vital signs, tracking urine output and color, and educating the family.
What if? If a patient with iron overload also has severe renal failure, deferoxamine may still be used, but hemodialysis would be required to remove the iron-deferoxamine complex from the blood, as the kidneys cannot excrete it.

How to Approach the Question

This is a factual recall question from pharmacology.
First, identify the substance causing toxicity in the question stem, which is 'iron'.
Next, review the options provided, which are all antidotes or specific treatments.
Recall the specific antidote for iron poisoning from your knowledge of toxicology and pharmacology.
Match 'iron' with its corresponding antidote, 'deferoxamine'. The other options are antidotes for different substances (opioids, digoxin) or a protectant agent (dexrazoxane).

Concept Tested & Keywords

Q33divpZ9d64X608LPbUpq

E6 Pharmacology Katzung 16e p. 1604-1606

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 pp. 776-778, 778-780

Practise the full DHS Staff Nurse - 2018 (Shift-2nd)

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