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- hypermetabolic state:
- hyperpnoea (causing respiratory alkalosis)
- metabolic acidosis.
- Inhibit acetylcholinesterase= parasympathetic/Ach effects
- Hypersalivation, bronchorrhoea, broncho spasms, perspiration, neuromuscular paralysis.
- A weak acid, causes lactic acidosis and optic neuritis.
- Blindness, pulmonary oedema, metabolic acidosis, shock.
Coma, hypotension, hypoventilation, reduced muscle tone and diminished reflexes. Pupils are normal in size.
Dysphagia, dysphoria, trismus, oculogyric crisis.
Gastric lavage is a priority.Serum iron is estimated at presentation.Gastrointestinal symptoms are common with:
- Abdominal distension
- Symptoms of intestinal haemorrhage.
Perforation of the bowel is expected. Severe hypotension may occur.
- The next stage of poisoning may give the paediatrician a false sense of security when the patient appears to improve. This is the stage of the iron being absorbed and accumulated into the mitochondria.
- Cellular damage occurs and features of hepatic toxicity with a metabolic acidosis and hypoglycaemia develop.
- Severe hepatic necrosis results in jaundice, deranged liver function and clotting abnormalities.
- Treatment = IV desferrioxamine and supportive treatment.
- colicky abdominal pain
- failure to thrive with pallor from anaemia.
- If severe may present with encephalopathy (drowsiness, convulsions and coma, with papilloedema).
- Treat with chelation (penicillinae or EDTA)