(Available Forms Of Iron)

Oral

Tablets (regular and sustained release), capsules, elixirs,

suspensions, syrups, and drops

Prenatal products tend to contain 60 – 100 mg elemental

iron per tablet.

Chewable multivitamins with iron tend to contain 15 – 18

mg elemental iron per tablet.

Parenteral

Iron dextran (ferric hydroxide complexed to dextran)

Vitamin a

Available forms

Food: Either preformed vitamin A (liver) or as carotenoids

(carrots).

Vitamin Preparations: Multiple vitamins typically contain

5000 IU per dose

Poisoning Manifestations

Acute: Nausea, vomiting diarrhea, headache, drowsiness

irritability, and blurred vision. This is followed in 24-72

hours by extensive desquamation.

Chronic: Bone abnormalities (asynchronous growth,

exostoses , metaphyseal flares, epiphyseal premature

closures), hepatotoxicity, intracranial hypertension (blurred

vision, headaches, diplopia), hypercalcemia

Vitamin a

Toxic Dose

Acute Toxic Dose: >25,000 IU/kg

Chronic Toxic Dose: 25,000-50,000 IU/day for as few as

30 days.

Treatment

Supportive Care

Increased intracranial pressure

Daily lumbar puncture, 40 mg IV furosemide, 1 gram/kg of

mannitol, 250 mg acetazolamide QID, a short course of

prednisone

Hypercalcemia

Loop diuretics, IV fluids and prednisone (20 mg/day)

Preventing absorption

Activated charcoal, lavage, or ipecac syrup

Vitamin b3 (Niacin)

Available forms

Multiple vitamins typically contain 20-30 mg per dose

Poisoning Manifestations

Nausea, gastritis, and diarrhea. Severe flushing and

pruritus (prostaglandin mediated histamine release).

Chronic high dose associated with hyperuricemia, glucose

intolerance, and hepatotoxicity.

Toxic Dose

Acute Toxic Dose: 100 mg

Chronic Toxic Dose: 750 mg/day for several months

Treatment

Pre-treatment with aspirin

Vitamin b6 (Pryridoxine)

Available forms

Multiple vitamins typically contain 1-6 mg per dose. Also

available in 50-500 mg tablets and solution for injection

(100 mg/mL).

Poisoning Manifestations

Peripheral neuropathy (loss of proprioception and pain,

temperature, and vibratory sensations; loss of tendon

reflexes)

Toxic Dose

Acute Toxic Dose: 132 – 183 gram

Chronic Toxic Dose: 2-5 gram/day for several months

Treatment: Prevent absorption for massive

Ingestions

Vitamin c (Ascorbic Acid)

Available forms

Multiple vitamins typically contain 60 – 300 mg per dose.

Tablets, capsules and solutions for injection are also

available.

Poisoning Manifestations

Chronic high dose associated with diarrhea and urinary

nepholithiasis. Massive acute dose is associated with

nephropathy and renal failure.

Toxic Dose

Acute Toxic Dose: 40-50 grams IV

Chronic Toxic Dose: 2 grams/day for several months

Treatment: Hemodialysis if patients develop renal

failure/insufficiency