Over the past several weeks, a 2-year-old girl has exhibited developmental regression, abnormal sleep patterns, anorexia, irritability, and decreased activity. These symptoms have progressed to acute encephalopathy with vomiting, ataxia, and variable consciousness. The family recently moved, and they are in the process of restoring the interior of their home. For the most likely toxic substance involved in the cases above, select the appropriate treatment
The most important aspect of the management of lead poisoning is the identification and withdrawal of the source of the lead. Patients with symptomatic lead poisoning or extremely high lead levels in the blood (> 70 mg/dL) should be treated with both dimercaprol and calcium EDTA. With milder poisoning, intravenous or intramuscular calcium EDTA or, more likely, oral dimercaptosuccinic acid can be used.
Atropine and pralidoxime (2-PAM)
N- acetylcysteine (Mucomyst)
Dimercaptosuccinic acid (DMSA, succimer)
Naloxone (Narcan)
Growth, Development, and Behavior