Iron toxicity in the human body, its mechanism, and effects, How iron toxicity can be treated pharmaceutically and the drugs administered. Mechanism of iron absorption in the body.

1. Iron toxicity!
Presented by: Fahima Jannat Koly
Roll: SK-66
BPharm Professionals Year-2

2. What is iron toxicity?
• Iron toxicity occurs when the body has too much iron. The most
common cause of iron toxicity is accidental overdose of iron pills.
• Iron poisoning is an iron overload caused by a large excess
of iron intake and usually refers to an acute overload rather than a
gradual one. The term has been primarily associated with young
children who consumed large quantities of iron supplement pills,
which resemble sweets and are widely used, including by pregnant
women; approximately 3 grams is lethal for a two-year-old.
• Iron overload may develop chronically as well, especially in patients
requiring multiple transfusions of red blood cells. This condition
develops in patients with sickle cell disease, thalassemia, and
hematologic malignancies such as myelodysplastic syndromes.

3. • The amount of iron ingested may give a clue to potential toxicity. The
therapeutic dose for iron deficiency anemia is 3–6 mg/kg/day. Toxic
effects begin to occur at doses above 10–20 mg/kg of elemental iron.
Ingestions of more than 50 mg/kg of elemental iron are associated with
severe toxicity.
• A 325-mg tablet of ferrous sulfate heptahydrate has 65 mg (20%) of
elemental iron
• A 325-mg tablet of ferrous gluconate has 39 mg (12%) of elemental iron
• A 325-mg tablet of ferrous fumarate has 107.25 mg (33%) of elemental
iron
• 200 mg ferrous sulfate, dried, has 65 mg (33%) of elemental iron
• In terms of blood values, iron levels above 350–500 µg/dL are considered
toxic, and levels over 1000 µg/dL indicate severe iron poisoning
Toxic Dose:

4. Signs, Symptoms and Diagnosis:

5. Mechanism of Iron Poisoning:

6. Treatment of iron toxicity and antidotes used:
• Later stage treatment consists of cleaning the iron from the blood,
using a chelating agent such as deferoxamine. If this fails
then dialysis is the next step.
• The goals of pharmacotherapy are to reduce iron levels, prevent
complications, and reduce morbidity. Deferoxamine (Desferal) is used
for chelation of iron in both acute and chronic toxicity.
• The oral chelating agent deferasirox (Exjade) is approved by the US
Food and Drug Administration (FDA) for the treatment of chronic iron
overload due to blood transfusions in patients 2 year of age and
older; it is also approved for treatment of chronic iron overload
resulting from non–transfusion-dependent thalassemia.

7. Pharmacology
•Mechanism of Action
• Desferal chelates iron by forming a stable complex that prevents the
iron from entering into further chemical reactions; also chelates iron
readily from ferritin and hemosiderin but not readily from transferrin;
does not combine with the iron from cytochromes and hemoglobin;
chelate is readily soluble and is renally excreted
•Pharmacokinetics
• Metabolism: Principally by plasma enzymes; pathways not yet
defined
• Excretion: Primarily urine; partly excreted in feces
• 100mg of deferoxamine binds to about 10mg of iron and 4.1mg of
aluminum

8. Formulation, Dosage forms and administration:
• Preparation for IM administration: 500mg with 2mL SWI/ 2g with 8mL
SWI (final concentration after reconstitution for both: 213mg/mL)
• Preparation for IV administration: 500mg with 5mL SWI/ 2g with 20mL
SWI (final concentration after reconstitution for both: 95mg/mL)
• Preparation for SC administration: 500mg with 5mL SWI/ 2g with 20mL
SWI (final concentration after reconstitution for both: 95mg/mL)
• Use immediately; ≤ 3hours of reconstitution
• When reconstitution is carried under aseptic conditions, may store ≤ 24 hr at
25°C; do not refrigerate; do not reconstitute with other solvents or under
different conditions due to risk of precipitation

9. Iron toxicity at a glance

10. Any Queries?
•Thank you!!!!!! 