Pentetate Calcium Trisodium Ca DTPA

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What is Pentetate Calcium Trisodium Ca DTPA

Pentetate calcium trisodium contains the sodium salt of calcium diethylenetriaminepentaacetate, a chelating agent.

Pentetate calcium trisodium is also known as trisodium calcium diethylenetriaminepentaacetate and is commonly referred to as Ca-DTPA. Ca-DTPA, like its counterpart Zn-DTPA, is given intravenously or by inhalation and is used for the treatment of known or possible internal contamination with plutonium, americium or curium.

Chelation treatment should begin immediately, with contamination verified as soon as possible.

If treatment cannot be started right away, patients should begin treatment as soon as it becomes available, as treatment is still effective even after time has elapsed since exposure.

Ca-DTPA and Zn-DTPA should not be administered simultaneously due to the duplicative nature of the treatments. If both products are available, Ca-DTPA should be given as the first dose.

If additional treatment is needed, treatment should be switched to Zn-DTPA, if Zn-DTPA is available (See Zn-DTPA monograph).

This treatment 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, but Ca-DTPA causes more mineral loss.

Therefore, Zn-DTPA is preferred for maintenance therapy. When the sources of radiation contamination are multiple or unknown, other therapies (such as potassium iodide, insoluble Prussian blue, or sodium alginate) can be used together with zinc or calcium DTPA.

The U.S. national stockpile of products for emergency use includes stores of Ca-DTPA and Zn-DTPA. Those who are concerned about the possibility of being contaminated with radioactive plutonium, americium or curium should be encouraged to discuss such issues with their health care provider for advice and treatment.

In September, 2003, the FDA determined that Ca-DTPA is safe and effective for treatment of radioactive contamination due to the elements plutonium, americium and curium, and encouraged manufacturers to submit NDAs for products.

A Ca-DTPA product of Hameln Pharmaceuticals received FDA approval on August 11, 2004.

Indications

  • radiation exposure

For treatment of individuals with known or suspected internal contamination with radiation exposure to plutonium, americium, or curium to increase the rates of elimination

Side Effects

  1. chest pain (unspecified)
  2. cough
  3. diarrhea
  4. dizziness
  5. dysgeusia
  6. headache
  7. hypomagnesemia
  8. injection site reaction
  9. metallic taste
  10. nausea
  11. rash
  12. vomiting
  13. wheezing
  14. zinc deficiency

Monitoring Parameters

  • CBC with differential
  • serum creatinine/BUN
  • serum electrolytes

Contraindications

  • asthma
  • bone marrow suppression
  • breast-feeding
  • burns
  • children
  • dialysis
  • electrolyte imbalance
  • hemochromatosis
  • hypomagnesemia
  • infants
  • neonates
  • neutropenia
  • pregnancy
  • pulmonary disease
  • renal failure
  • renal impairment
  • thrombocytopenia
  • trauma
  • zinc deficiency

Interactions

There are no drug interactions associated with Pentetate Calcium Trisodium, Ca-DTPA products.

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