Signs and symptoms of overdosage: Vitamin A: Chronic daily vitamin A intakes in excess of 10,000 IU or weekly intakes in excess of 25,000 IU have resulted in hypervitaminosis A. Early signs of hypervitaminosis A include fatigue, lethargy (lack of energy), irritability, malaise/depression, loss of appetite, abdominal pain/discomfort, nausea and vomiting, mild fever, and excessive sweating. Treatment of hypervitaminosis A consists of discontinuance of vitamin A and supportive therapy as indicated.
High doses of vitamin A can also cause blurred vision, dizziness, drowsiness, headache insomnia, irritability, lack of muscle coordination, osteoporosis, osteosclerosis, and seizures.
Iron: Acute iron overdosage (e.g., intake of 1,500 mg elemental iron for a 50 kg adult) can be divided into four stages: Stage I: Occurs up to six hours after ingestion, the principal symptoms are vomiting and diarrhea. Other symptoms include hypotension, tachycardia (rapid heartbeat) and central nervous system depression ranging from lethargy (sleepiness) to coma (state of unconsciousness).
Stage II: May occur 6 to 24 hours after ingestion and is characterized by a temporary remission or signs of overdosage are decreased.
Stage III: GI symptoms recur accompanied by shock, metabolic acidosis (increased acid in the blood), coma, hepatic necrosis (death of liver tissue), jaundice (yellowish color of the skin, eyes and other tissues), hypoglycemia (low blood sugar), kidney failure, and pulmonary edema (fluid in the lungs).
Stage IV: Occurs several weeks after ingestion and is characterized by GI obstruction (blockage) and liver damage.
What to do if the patient has taken more than the recommended dosage: If the patient has taken more than the recommended dosage, consult a doctor or contact a poison control center immediately.
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