a child of 4yrs playing with painted toys since 2yrs, habitually places in the mouth and after 6hrs develops drowsiness, fever ,constipation with abdominal pain .what is the treatment of choice: (A) edta+ dimercaprol, (B) DMSA, (C) D-PENCILLAMINE, (D) BAL
Answer is A. Treatment: OF LEAD POISONING 1. Suppoive measures: gastric lavage, intravenous fluids, cardiac monitoring, etc. 2. Chelation therapy: This can be done with -- * BAL(British Anti Lewesite or dimercaprol)- 3to5mg/kg IM every 4 hrs until the urinary excretion dips below 50mcg/24hrs . Usual duration of therapy is 7to10 days. * Penicillamine -- can be given orally at a dose of 100mg/kg/day, 6th hourly for 5 days. * DMSA(Dimercapto succinic acid), or DMPS(Dimercapto propane sulfonic acid).- superior to BAL and penicillamine. REF : NARAYANAREDDY 9TH ED