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Pediatrics General 40db92e3

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 –

A
EDTA
B
DMSA
C
BAL
D
Pencillarnine
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.

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