Metals
Frank A. Barile in Barile’s Clinical Toxicology, 2019
Deferoxamine is an aluminum (Al) and iron (Fe(II)) chelator that is beneficial in the treatment of acute and chronic Fe poisoning and for Al overload. The compound is isolated from bacteria (Streptomyces pilosus) and is one of the few chelators recommended for the alleviation of secondary Fe overload. It is not effective orally and requires continuous subcutaneous administration to achieve efficient Fe elimination. Figure 26.4 illustrates the structure of deferoxamine with a chelated Fe moiety. It preferentially binds both free and bound Fe from hemosiderin and ferritin but not Fe contained in hemoglobin, transferrin, or cytochromes. Chemical structure of deferoxamine with Fe in the reduced form.
Miscellaneous therapeutic and diagnostic agents
Bev-Lorraine True, Robert H. Dreisbach in Dreisbach’s HANDBOOK of POISONING, 2001
If there are iron tablets visible on X-ray, symptoms or signs of iron poisoning, or pink (‘vin rosé’) urine with good urine output, give chelation therapy with deferoxamine, 15 mg/kg/h by continuous intravenous infusion to a maximum of 80 mg/kg in each 12-h period. Monitor blood pressure during administration of deferoxamine, and reduce the rate of administration if the blood pressure falls. Single doses should not exceed 1 g and the maximum in 24 h should not exceed 6 g. Deferoxamine is hazardous in patients with severe renal disease or anuria, and dialysis is necessary in such cases. Injected deferoxamine is associated with a high risk and should be reserved for serious poisoning. Continue deferoxamine therapy until the patient is free from symptoms and signs for 24 h.
Iron Poisoning
Sam Kacew in Drug Toxicity and Metabolism in Pediatrics, 1990
Studies addressing the question of bioavailability of the iron-deferoxamine complex have failed to provide useful information for the management of iron intoxication. When deferoxamine is used orally in chronic iron overload states, the bioavailability of iron is decreased.20,21 However, in animal studies of acute iron overdose, the iron-deferoxamine complex is absorbed.22
The combination of deferoxamine and minocycline strengthens neuroprotective effect on acute intracerebral hemorrhage in rats
Published in Neurological Research, 2021
Zhe Li, Yang Liu, Ruixue Wei, Suliman Khan, Mengzhou Xue, V. Wee Yong
After ICH, a large amount of iron is released from the destruction of erythrocytes. As one of the main degradation products of hemoglobin, iron ions cause brain edema and cell death after ICH through the activation of a series of oxygen-free radicals and inflammatory reactions [32,33]. The Iron overload around the hematoma will lead to large amounts of reactive oxygen species and lipid peroxidation, thereby aggravating secondary brain damage [34]. Deferoxamine, as a kind of iron chelator, has a strong affinity for Fe3+, which can quickly excreted from the body and reduce the pathological deposition of iron in the body [35]. After systemic administration, deferoxamine can rapidly penetrate the blood-brain barrier, accumulate in high concentration in local brain tissue [36], and reduce the content of iron ion in hematoma, thereby reducing the secondary neuronal damage after ICH. Several studies have shown that deferoxamine can attenuate hemoglobin-related edema [17], neuronal death, neurological deficits and brain atrophy in animal ICH models [15,16,37]. Our study demonstrated that DFX treatment reduced the accumulation of iron, neuronal death, and the improvement in forelimb placement and corner tests compare with the vehicle group. Most worthy of mention is that our study found the combination treatment has a better therapeutic effect, which may be related to the iron chelation effect of minocycline.
Complement activation and coagulopathy - an ominous duo in COVID19
Published in Expert Review of Hematology, 2021
Sojit Tomo, Kiran Pvsn Kumar, Dipayan Roy, Shrimanjunath Sankanagoudar, Purvi Purohit, Dharamveer Yadav, Mithu Banerjee, Praveen Sharma, Sanjeev Misra
Similarly, COVID-19 also results in remarkably high ferritin levels, a negative prognostic marker, because of its detrimental effects on the endothelium, coagulation, and organs. Deferoxamine or Deferiprone are two major drugs known for iron chelation. Deferoxamine was shown to work also as hypoxia-inducing factor (HIF)-mimetic, downregulating hepcidin. Iron chelation with deferiprone observed a recovery of immune status and cytokine pattern in thalassemia [124]. Emerging studies indicate that iron manipulation, such as iron chelation, is a promising adjuvant therapy in treating viral infection [125]. While the emerging viral infection by SARS-CoV-2 is much less understood compared with HIV-1 or SARS-CoV and MERS-CoV, based on the previous studies, it is plausible that deprivation of iron supply to the virus could serve as a beneficial adjuvant in treatment, with the prerequisite of adequate understandings on one’s iron status, such as serum iron and ferritin levels, and globin content.
Drug safety in thalassemia: lessons from the present and directions for the future
Published in Expert Opinion on Drug Safety, 2021
Laura Grech, Janet Sultana, Karen Borg, Joseph Borg
Deferoxamine (Desferal® or desferrioxamine) is produced by bacterium Streptomyces pilosus [20]. It was the first clinically approved iron chelator for treatment of β-thalassemia and has been in use from 1980s [21]. Deferoxamine is a hexadentate iron chelator that treats iron toxicity by binding trivalent ferric iron to form a stable complex known as ferrioxamine [22] (Table 1). Deferoxamine adverse drug reactions (ADRs) include irritation at the infusion site, skeletal changes, growth retardation, and ocular or auditory disturbances, while respiratory distress was reported with high intravenous doses [23–25]. In rare cases, it was also shown that deferoxamine is a risk factor for Yersina adenomesenteritis infections, including sepsis, as this drug may increase host iron bioavailability [26,27].
Related Knowledge Centers
- Blood Transfusion
- Intramuscular Injection
- Iron
- Iron Overload
- Aluminium
- Iron Poisoning
- Genetic Disorder
- Aluminium Toxicity In People On Dialysis
- Kidney Dialysis
- Intravenous Therapy