A child is brought with drowsiness, decreased deep tendon reflexes and seizures. On examination, the child has a line on gums. There is a history of constipation. Which will be a most appropriate drug that should be used in this child –
High-Yield Explanation
Clinical features of child suggest the diagnosis of lead poisoning with encephalopathy.
Chelation therapy for lead poisoning -
Guidelines for selecting children for chelation in lead poisoning are based on blood lead level.
Four drugs are available-DMSA, EDTA, Penicillamine, BAL.
DMSA and penicillamine can be given orally while EDTA and BAL can only be administered parenterally.
Children with blood lead levels between 44 and 70 should be treated with a single drug. Those with blood levels of 70 or greater require 2 drug treatment.
EDTA in combination with either DMSA or BAL for those without encephalopathy.
EDTA and BAL for those with encephalopathy.