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Question

An 8 year old child has consumed a few tablets of a drug that were being taken by his motheron a regular basis. Following this the child develops gastric necrosis, acidosis, shock and hepatic necrosis. Which is the most likely drug?

The correct answer is
Iron

Identifying the Toxic Drug Based on Symptoms

The question describes a scenario where an 8-year-old child ingested several tablets of a medication, leading to severe symptoms including gastric necrosis, acidosis, shock, and hepatic necrosis. We need to identify the most likely drug responsible.

Analyzing Symptoms of Drug Toxicity

  • Gastric Necrosis: Severe irritation and damage to the stomach lining.
  • Acidosis: A condition where there is too much acid in the body fluids.
  • Shock: A life-threatening condition due to insufficient blood flow.
  • Hepatic Necrosis: Death of liver cells.

Evaluating Medication Options

  • Multivitamins: Generally safe in moderate overdose; unlikely to cause such severe, specific toxicity.
  • Calcium Carbonate: Overdose can cause hypercalcemia and GI upset, but not typically necrosis or shock.
  • Folic Acid: Very low toxicity; overdose symptoms are rare and mild.
  • Iron: Iron supplements are well-known to be highly toxic in overdose, especially in children. The symptoms described—severe gastrointestinal distress (leading to necrosis), metabolic acidosis, cardiovascular collapse (shock), and liver damage (hepatic necrosis)—are classic signs of acute iron poisoning.

Conclusion on Most Likely Drug

Based on the severe symptoms of gastric necrosis, acidosis, shock, and hepatic necrosis, iron overdose is the most probable cause.

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Important Questions from Childhood Injuries and Poisoning

  1. Consider the following pairs :
    Urine colourPossible causative agent in a child with suspected poisoning
    1. Pink- Cephalosporin
    2. Brown- Chloroquine
    3. Greenish blue- Phenazopyridine
    4. Red-orange- Amitriptyline
    How many of the pairs given above are correctly matched ?
  2. A child presents to the emergency following ingestion of around 20 mL of kerosene oil about 40 minutes back. The child appears stable. Which one of the following measures should be done for the management of the child?
  3. In case of a child with an acute poisoning by ingestion, activated charcoal may be used in which one of the following situations?
  4. After sustaining a head injury, an 18 month old child displays eye opening only to pain, moans on painful stimuli and withdraws to painful stimuli. What is the modified Glasgow Coma Scale Score in this child ?
  5. In a child with acute organophosphorus poisoning, which one of the following drugs will act as anti-sialogogue and peripheral parasympatholytic agent?

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