Toxicology and antidotes: whole bowel irrigation: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Toxicology and antidotes: whole bowel irrigation

Sample item

A toddler has swallowed many ferrous sulfate tablets, and an abdominal film shows numerous tablets in the stomach and small bowel. Activated charcoal does not bind iron. Which gut decontamination method is most appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Whole bowel irrigation with polyethylene glycol

Whole bowel irrigation flushes pills through the gut with a non-absorbable polyethylene glycol solution, and is used for iron tablets, sustained-release drugs and packets of drugs. Charcoal does not adsorb iron and ipecac is no longer recommended. Deferoxamine is the chelating antidote for systemic iron toxicity.

Option by option

  • A. Forced alkaline diuresis with bicarbonate

    Forced alkaline diuresis enhances the excretion of salicylates, not of iron.

  • B. Activated charcoal 1 g/kg by nasogastric tube

    Activated charcoal does not adsorb iron salts.

  • C. Syrup of ipecac to induce emesis

    Ipecac-induced emesis is not recommended because it is ineffective and risks aspiration.

  • D. Whole bowel irrigation with polyethylene glycol (correct)

    Correct. Polyethylene glycol irrigation clears iron tablets from the gut.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Whole bowel irrigation with polyethylene glycol. Whole bowel irrigation flushes pills through the gut with a non-absorbable polyethylene glycol solution, and is used for iron tablets, sustained-release drugs and packets of drugs.

Why is "Forced alkaline diuresis with bicarbonate" not the answer?

Forced alkaline diuresis enhances the excretion of salicylates, not of iron.

Why is "Activated charcoal 1 g/kg by nasogastric tube" not the answer?

Activated charcoal does not adsorb iron salts.

Why is "Syrup of ipecac to induce emesis" not the answer?

Ipecac-induced emesis is not recommended because it is ineffective and risks aspiration.

What concept does this question test?

It tests Toxicology and antidotes: whole bowel irrigation in Pharmacology. Charcoal does not adsorb iron and ipecac is no longer recommended. Deferoxamine is the chelating antidote for systemic iron toxicity.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Toxicology and antidotes: whole bowel irrigation?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.