Question

The physician has ordered chelation therapy for a child with hemosiderosis, a complication associated with thalassemia major. Chelation therapy includes the administration of vitamin \(C\) and: A. Chemet (succimer) B. Desferal (deferoxamine mesylate) C. Calcium EDTA (edetate calcium disodium) D. British anti-Lewisite (dimercaprol)

Short answer

Answer: Desferal (deferoxamine mesylate)

Step-by-step solution

Understand Chelation Therapy and Hemosiderosis

Chelation therapy is a medical treatment that involves the administration of chelating agents to remove heavy metals and other toxins from the body. Hemosiderosis is a condition where excessive iron accumulates in the body's tissues and organs, which can result from blood transfusions used to treat thalassemia major. In this case, chelation therapy is used to remove the excess iron and prevent potential damage to organs.

Review the Drug Options

There are four drug options listed: A. Chemet (succimer) B. Desferal (deferoxamine mesylate) C. Calcium EDTA (edetate calcium disodium) D. British anti-Lewisite (dimercaprol)

Eliminate Incorrect Options

Now, let's eliminate the incorrect drug options for chelation therapy in the treatment of hemosiderosis: - Chemet (succimer) is primarily used for treating lead poisoning. - Calcium EDTA (edetate calcium disodium) is used for treating lead poisoning and other heavy metal poisonings. - British anti-Lewisite (dimercaprol) is used to treat arsenic, gold, and mercury poisoning. These three options are not commonly used for the treatment of hemosiderosis associated with thalassemia major.

Choose the Correct Option

The remaining option is the correct choice for chelation therapy in treating hemosiderosis in a child with thalassemia major: B. Desferal (deferoxamine mesylate) Desferal is a chelating agent that binds to iron and helps to remove excess iron from the body. It is commonly used in the treatment of hemosiderosis associated with thalassemia major.

Key concepts

Hemosiderosis

Hemosiderosis is a condition characterized by the excessive buildup of iron in the body's tissues and organs. This can happen due to repeated blood transfusions, which are often necessary for patients with certain medical conditions like thalassemia major. When the body gets too much iron, it can't adequately eliminate the excess, leading to potential complications.
Symptoms of hemosiderosis can vary but may include fatigue, joint pain, and skin discoloration. If not treated, it can result in more severe complications involving vital organs such as the liver and heart. Therefore, early identification and management are essential to prevent further health issues.

Thalassemia Major

Thalassemia Major, also known as Cooley's anemia, is a severe blood disorder where the production of hemoglobin is insufficient. Hemoglobin is crucial for carrying oxygen in the blood, and when there is not enough, it leads to anemia.
This condition is typically inherited, meaning it runs in families. Patients with thalassemia major often require regular blood transfusions to sustain normal hemoglobin levels and maintain their health. These frequent transfusions, however, can result in iron overload, necessitating further treatment such as chelation therapy to manage and eliminate excess iron.

Deferoxamine Mesylate

Deferoxamine Mesylate, commonly known by its trade name Desferal, is a chelating agent used specifically to combat iron overload in patients. It works by binding to excess iron in the bloodstream, which allows the body to excrete the bound iron through the kidneys.
This medication is particularly important in managing hemosiderosis in individuals with thalassemia major who undergo regular blood transfusions. Deferoxamine Mesylate can be administered subcutaneously, intramuscularly, or intravenously, depending on the patient's needs and clinical scenario. Effective use of this drug is essential in preventing the toxic effects of iron overload.

Iron Overload Treatment

Iron overload treatment involves several approaches, with chelation therapy being one of the most effective and commonly used methods. Chelation therapy is crucial for patients whose conditions, like thalassemia major, result in iron accumulation due to regular blood transfusions.
In chelation therapy, drugs like Deferoxamine Mesylate are given to bind excess iron and help remove it from the body. This process reduces the risk of damage that free iron might cause to vital organs.

• Monitoring iron levels: Regular tests are conducted to check iron levels and ensure that treatment is working effectively.
• Lifestyle adjustments: Patients may need to adopt diet changes or other lifestyle adjustments to support treatment.

Optimal treatment generally requires a comprehensive plan tailored to the individual's health needs.