Which treatment is recommended for a patient who has ingested lithium, lead, or iron within an hour?

Activated charcoal is the recommended treatment for a patient who has ingested lithium, lead, or iron within an hour because it effectively adsorbs many substances, preventing their absorption in the gastrointestinal tract. The use of activated charcoal is particularly beneficial in cases of acute poisoning where the substance involved is known to be adsorbed by charcoal.

For substances like lithium and lead, rapid intervention is crucial as they can have significant toxic effects. Administering activated charcoal shortly after ingestion can significantly reduce the amount of the toxin that enters systemic circulation, potentially mitigating the severity of toxicity. Additionally, activated charcoal is relatively easy to administer and has a favorable safety profile in acute poisonings when used appropriately.

The other options may have limited or no efficacy in this scenario. Gastric lavage, while historically used, is generally not recommended due to its potential risks and lack of proven benefit compared to activated charcoal. Intravenous fluids may be supportive in managing complications of poisoning but do not directly mitigate the absorption of these toxins. Antidotes may be appropriate for specific toxins, but there are no universal antidotes for lithium, lead, or iron that apply in this context. Therefore, activated charcoal is the most appropriate and recommended treatment for recent exposures to these toxic substances.