Pharm chelation therapy Flashcards Preview

ABBEY MSII U6 > Pharm chelation therapy > Flashcards

Flashcards in Pharm chelation therapy Deck (46)
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31

normal role of iron

various intracellular processes (accepts and donates electrons), extracellular is bound to transferrin

32

when does iron toxicity occur?

free iron in circulation

33

what are the pharmacokinetics of iron?

peak serum concentrations occur 2-6 hours after ingestion (overwhelmed transferrin and increase in circulating free iron)

34

local toxicity of iron

direct corrosive effect to GI mucosa (leading to hematemesis, melena, periportal necrosis of liver and intetional ulceration and edema)
-resultant volume depletion

35

systemic toxicity of iron

-high anion gap metabolic acidosis
-uncoupler of oxidative phosphorylation!
-direct negative inotropic effect
-hypotension (vasodilator)

36

early clinical effects of iron toxicity

local tissue effects of GI tract (nausea and lots of vomiting) within 6 hours

37

intermediate clinical effects of iron toxicity

nausea and vomiting may temporarily decrease with an increase in development of metabolic acidosis and sequelae

38

late signs of iron toxicity

severe local and system effects - hepatotoxicity, ARDS, renal, gastric outlet obstruction

39

chelator for iron poisoning

deferoxamine

40

deferoxamine mechanism

chelates FREE iron and iron transported between transferrin and ferritin

41

deferoxamine side effects

rate-related hypotension, anaphylactoid reactions, yersinia enterocolitis (facilitates growth of unusual organisms), acute lung injury/ARDS
-can only treat for 24 hours before acute lung injury manifests

42

clinical pearls for lead poisoning in kids

colic, lower levels associated with IQ changes, think PICA

43

clinical pearls for lead poisoning in adults

hypertension, tolerate higher lead levels

44

clinical pearls for arsenic poisoning

rice-water diarrhea, prolonged QT, arsenical dermatitis, "rain drops on a dusty road"

45

clinical pearls for mercury poisoning

labile mood "mad as a hatter", intention tremor, mercury salts: caustic

46

clinical pearls for thallium

painful neuropathy, alopecia