Substance
Iron salts

Pathology
Several mechanisms: direct corrosive effects on GI mucosa, hepatocellular toxicity, cardiovascular compromise, metabolic acidosis. Neurological manifestations are caused by hypoperfusion, metabolic acidosis, and hepatic compromise.

Symptoms
Nausea, vomiting, severe gastroenteritis, hematemesis, diarrhea, tachypnea, tachycardia, hypotension, lethargy, cyanosis, convulsions, coma, shock, or death.

Emergency Measures
Use gastric lavage or whole-bowel irrigation to remove tablets from the gastrointestinal tract. Intravenous deferoxamine is used as an iron-chelating agent.

Comments
Patients with systemic complications require hospital admission, constant monitoring, and supportive care until resolution. Late complications (2–8 wk) include GI stricture and obstruction. Toxicity is unlikely at a dose <20 mg/kg.