Poisning Center - Pediatric On Call

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katiha...

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POISIONING CENTER

Drug

Treatment Details

Iodine

It occurs as bluish-black, soft and scaly crystals and has a metallic lustre and an unpleasant taste. It gives off a violet-coloured vapour at all temperatures which has a characteristic odour.

Route : Inhalation, Ingestion

Fatal dose : 2-4 g. (30-60 ml. of tincture)

Fatal Period : 24 hours

Mechanism of action : It is a protoplasmic poison fixing protein and causing necrosis. Vapours irritate respiratory passages.

Clinical picture : Inhalation produces glottic and pulmonary oedema. Swallowed in the solid form, it acts as an acid corrosive poison. There is burning pain extending from the mouth to the stomach, intense thirst, salivation, vomiting, purging, giddiness, cramps or compulsive movements of the limbs and fainting. The lips and angles of the mouth are stained brown. The vomited matter and excreta are dark-yellow or blue in colour, contain blood and have the peculiar odour of iodine. The urine is scanty or suppressed, red-brown in colour, contains albumin` metabolic acidosis, nephritis and renal failure occur. Pulse is slow and weak, skin is cold and clammy and there may be skin rashes.

Chronic Poisoning {Iodism}:
The symptoms are pain over the frontal sinus, running of the nose, conjunctivitis, bronchial catarrh, salivation, nausea, vomiting, purging, emaciation, lymphadenopathy, parotid swelling {iodide mumps}, wasting of breasts, testes, etc. and acne or erythematous patches on the skin, urticaria {ioderma}.
Iodine rarely causes poisoning but cases may occur from overdose and idiosyncrasy. Iodine is converted to iodide in the body. The normal iodide content of blood is 2-5mg, 100ml.

Treatment : 1. Evacuate the stomach by emetics or wash it out with warm water containing soluble starch and albumin.
2. 1-5 percent solution of sodium thiosulphate will convert tincture of iodine to harmless iodide,
3. Sodium chloride will promote excretion of iodide, as chlorides compete with iodide at the level of the tubules, thereby reducing the effects of iodism.
4. Give alkalis, arrow root, and barley water and treat symptomatically.
5. Activated charcoal binds iodine.
6. Skin lesion can be treated with 20 percent alcohol.

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Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

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