An 18-month-old ingests an unknown quantity of iron tablets from his mother's prenatal supply. He presents 3 hours later with vomiting, diarrhea, and lethargy. Serum iron level is 580 micrograms/dL. Which of the following is the correct antidote and route of administration?
- A Deferrioxamine 15 mg/kg/hour IV infusion ✓
- B Deferiprone 25 mg/kg oral
- C Desferrioxamine 5 g oral lavage
- D EDTA 70 mg/kg IV over 4 hours
Correct answer: A. Deferrioxamine 15 mg/kg/hour IV infusion
Explanation
Deferoxamine (desferrioxamine) IV infusion at 15 mg/kg/hour is the antidote for severe iron poisoning (serum iron >500 micrograms/dL or symptomatic patients). It chelates free iron and forms ferrioxamine, which is renally excreted. The urine turns 'vin rosé' color confirming effectiveness. Oral deferoxamine is not appropriate as it is not absorbed and does not chelate systemic iron. Deferiprone is used for chronic iron overload, not acute poisoning.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.