The FDA has approved two injectable drugs, pentetate calcium trisodium (Ca-DTPA) and pentetate zinc trisodium (Zn-DTPA), for treating internal radiation contamination from plutonium, americium, or curium. The new drugs increase the rate of elimination of these radioactive materials from the body.
Ca-DTPA and Zn-DTPA have been used for several decades as investiga-tional agents in contamination emergencies. In September 2003, the Food and Drug Administration (FDA) announced specific conditions under which these drugs could be approved through new drug applications.
Internal contamination from radioactive materials can occur through inges-tion, inhalation, or direct contact through wounds. The goals of treatment with these new agents are to enhance the removal of contaminants and thus reduce the risk of future biological effects.
Ca-DTPA and Zn-DTPA should not be administered simultaneously. If both products are available, Ca-DTPA should be given as the first dose. If additional treatment is needed, patients should be switched to Zn-DTPA. This sequence is recommended because Ca-DTPA is more effective than Zn-DTPA during the first 24 hours after internal contamination; after the initial 24 hours, Zn-DTPA and Ca-DTPA are similarly effective.
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These agents are usually administered into the bloodstream. Nebulized inhalation can be used when contamination has occurred only by inhalation.
The main side effect of Ca-DTPA is the loss of essential nutritional metals such as zinc, which can be replaced by taking oral zinc supplements. Zn-DTPA may also decrease the levels of nutritional metals but to a lesser extent.
Some people experience breathing difficulties after inhalation therapy with these products.