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* consequence for iron-overdose (NBME)?
 #185442  
  pass123 - 05/11/07 20:28
 
  1. gastric bleeding
2. metabolic alkalosis
3. polycythemia
4 respiratory depression
5 urinary retention
 
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* Re:consequence for iron-overdose (NBME)?
#768253
  django32 - 05/11/07 21:21
 
  guys,
Be carefull with that question. Iron overdose is an acute event!! Polycythemia takes time at least several weeks to take place
 
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* Re:consequence for iron-overdose (NBME)?
#768260
  ros2 - 05/11/07 21:26
 
  how do we develope gastric bleeding in iron overdose... someone please share to explain  
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* Re:consequence for iron-overdose (NBME)?
#768275
  ros2 - 05/11/07 21:34
 
  hey guys got this from web path...
check this out ... this may explain the answer...

Iron Overload
Excessive iron can accumulate acutely or chronically.

Iron Poisoning: Acute iron poisoning is mainly seen in children. A single 300 mg tablet of ferrous sulfate will contain 60 mg of elemental iron. Toxicity producing gastrointestinal symptoms, including vomiting and diarrhea, occurs with ingestion of 20 mg of elemental iron per kg of body weight. If enough iron is ingested and absorbed, about 60 mg per kg body weight, systemic toxicity occurs. Toxicity results when free iron not bound to transferrin appears in the blood. This free iron can damage blood vessels and produce vasodilation with increased vascular permeability, leading to hypotension and metabolic acidosis. In addition, excessive iron damages mitochondria and causes lipid peroxidation, manifest mainly as renal and hepatic damage.Early signs of iron poisoning include vomiting and diarrhea, fever, hyperglycemia, and leukocytosis. Later signs include hypotension, metabolic acidosis, lethargy, seizures, and coma. Hyperbilirubinemia and elevated liver enzymes suggest liver injury, while proteinuria and appearance of tubular cells in urine suggest renal injury.

Chronic Iron Overload: This can occur in patients who receive multiple transfusions for anemias caused by anything other than blood loss. Patients with congenital anemias may require numerous transfusions for many years. Each unit of blood has 250 mg of iron.

Ineffective Erythropoiesis: Increased iron absorbtion can occur in certain types of anemia in which there is destruction of erythroid cells within the marrow, not peripheral destruction. This phenomenon signals the erythroid regulator to continually call for more iron absorbtion. These conditions include: thalassemias, congenital dyserythropoietic anemias, and sideroblastic anemias.


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References
Andrews NC. Disorders of iron metabolism. N Engl J Med. 1999;341:1986-1995.

Bothwell TH. Overview and mechanisms of iron regulation. Nutr Rev. 1995;53:237-45.

El-Serag HB, Inadomi JM, Kowdley KV. Screening for hereditary hemochromatosis in siblings and children of affected patients. A cost-effective analysis. Ann Intern Med. 2000;132:261-269.

Merryweather-Clarke AT, Pointon JJ, Shearman JD, Robson KJ. Global prevalence of putative haemochromatosis mutations. J Med Genet. 1997;34:275-278.

Provan D. Mechanisms and management of iron deficiency anaemia. Br J Haematol. 1999;105 Suppl 1:19-26.

Steinberg KK, Cogswell ME, Chang JC, et al. Prevalence of C282Y and H63D mutations in the hemochromatosis (HFE) gene in the United States. JAMA. 2001;285:2216-2222.

Uchida T. Overview of iron metabolism. Int J Hematol. 1995;62:193-202.
 
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* Re:consequence for iron-overdose (NBME)?
#768276
  armani - 05/11/07 21:35
 
  Iron has a corosive effect on Gastric lining... so it can bleed.

Django32.. i agree with you 100%, it is an acute event, which is why i thought met. alkalosis secondary to vomiting would be the 1st thing to happen, since vomiting would occur more quickly than a gastric bleed... although both are right.

Pass still waiting on answer bro..
 
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* Re:consequence for iron-overdose (NBME)?
#768281
  ros2 - 05/11/07 21:40
 
  ..am leaning towards Gi bleding...  
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* Re:consequence for iron-overdose (NBME)?
#768282
  pass123 - 05/11/07 21:45
 
  2yr child took the drug from mom  
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* Re:consequence for iron-overdose (NBME)?
#768287
  pass123 - 05/11/07 21:50
 
  the attached ans is GI bleeding.  
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* Re:consequence for iron-overdose (NBME)?
#768293
  django32 - 05/11/07 21:57
 
  Guys, in that question we should considere the chronology of each event. In that way I am 100% with Armani. The first event is vomiting which leads to metabolic alkalosis, respiratory depression by compensation. I think the sequence of theses events is the response of the organism to that "agression" ( iron overdose) than, the patient gonna bleed because of effort of vomiting ( Mallory Wice syndrome, I forget the orthograph) blood lost gonna lead to urine retention by activation of the system renin angiotansine aldosterone in order to maintain the mean arterial pressure. I am waiting for your comments guys.  
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* Re:consequence for iron-overdose (NBME)?
#768428
  harsh - 05/12/07 01:37
 
  its gi bleeding definitely no 2 doubts abt it..reference KD TRIPATHI BOOK OF PHARMACOLOGY..the basic pathology is tron causes haemorrrhagic necrosis og gut  
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* Re:consequence for iron-overdose (NBME)?
#769575
  pass123 - 05/12/07 23:12
 
  another iron-over dose q in form 2----Cause lipid peroxidation  
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