Iron; Benefits or threatens (with emphasis on mechanism and treatment of its poisoning).

Iron is a necessary biological element and one of the richest in the human body, but it can cause changes in cell function and activity control. Iron is involved in a wide range of oxidation - reduction activities. Whenever iron exceeds the cellular metabolic needs, its excess causes changes in the products of cellular respiration, such as superoxide, hydrogen peroxide and hydroxyl. The formation of these compounds causes cellular toxicity. Lack of control over reactive oxygen species causes damages to DNA, proteins, and lipids. Conversely, superoxide, hydrogen peroxide and hydroxyl are reactive oxygen species, using antioxidants, restoring DNA function, and controlling iron stores lead to natural conditions. Iron poisoning causes clinical manifestations in the gastrointestinal tract, liver, heart, kidneys, and hematopoietic system. When serum iron is elevated, serum iron concentrations, total iron-binding capacity (TIBC) and ferritin will also increase. Supportive care is provided by whole bowel irrigation (WBI), esophagogastroduodenoscopy is required to evaluate mucosal injury and remove undissolved iron tablets. The use of chelator agents such as deferoxamine mesylate, deferasirox, deferiprone, deferitrin are very effective in removing excess iron. Of course, the combined treatment of these chelators plays an important role in increasing iron excretion, and reducing side effects.

Drug interactions in elderly (Amirkola Health and Ageing Project).

Background: Due to physiological changes and co-existing chronic diseases, the elderly has to take various drugs with different mechanisms that may increase the risk of drug interactions and side effects of medications. This study was performed to evaluate the profile of drug interactions of Amirkola elderly patients. Methods: This cross-sectional descriptive-analytical study is part of the Amirkola Health and Ageing Project (AHAP) which was done during 2012-2013 (Amirkola, Babol, Iran). Initial data collection was done on 1616 persons of ages 60 and older by observing their prescribed drugs and those prepared by self-medications. Results: Drug interactions were detected in 31.7% (95% CI; 29.41, 33.95) of the drug prescriptions. This included 28% of mild, 63.3% of moderate and 8.7% of severe drug interactions. Cardiovascular drugs (64.4%) were the most frequent drugs that induced drug-interactions. According on Beer criteria 2015, 39.97% of the elderly medications were identified as "inappropriate medication". NSAIDs had the highest prevalence of inappropriate drugs. There was a significant relationship between female gender, having underlying disease, living alone, having insurance, and polypharmacy with obtained drug interaction results (p<0.05). Conclusion: The findings of the present study indicate considerable drug interactions among the elderly in Amirkola, which highlights the need for careful prescribing and using of drugs in the elderly.