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What is Pentetate Zinc Trisodium Zn DTPA
Pentetate zinc trisodium Zn DTPA is a radiomitigation chelating agent indicated for the treatment of individuals with known or suspected internal contamination with plutonium, americium, or curium.
Treatment with Zn-DTPA increases the rate of elimination of these radioactive contaminants.
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 in combination with Zn-DTPA. Chelation treatment should begin immediately, with contamination verified as soon as possible.
If treatment cannot be started right away, patients should begin therapy soon as it becomes available, as treatment is still effective even after time has elapsed since exposure.
Zn-DTPA should not be administered simultaneously with Ca-DTPA 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.
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.
The Zn-DTPA product labeling contains Black Box Warnings (BBW) regarding the potential for depletion of trace minerals and the potential for asthma exacerbation with inhaled administration
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
- cough
- dizziness
- headache
- pelvic pain
- wheezing
Monitoring Parameters
- CBC with differential
- serum creatinine/BUN
- serum electrolytes
- urinalysis
Contraindications
- asthma
- bone marrow suppression
- breast-feeding
- burns
- children
- dialysis
- electrolyte imbalance
- hypomagnesemia
- infants
- neonates
- neutropenia
- pregnancy
- pulmonary disease
- radiation exposure
- renal failure
- renal impairment
- thrombocytopenia
- trauma
Interactions
There are no drug interactions associated with Pentetate Zinc Trisodium, Zn-DTPA products.
Mechanism of Action
- Pentetate zinc trisodium (Zn-DTPA) forms stable chelates with metal ions by exchanging zinc for a metal of greater binding capacity. Zn-DTPA is effective for possible internal contamination with plutonium, americium, or curium. The radioactive chelates are then excreted by glomerular filtration into the urine.
- Zn-DTPA treatments are not expected to be effective for uranium and neptunium; radioactive iodine is not bound by DTPA. Based on the mechanism of action, Zn-DTPA may bind other elements or minerals (e.g., magnesium), and cause electrolyte or other nutritional imbalances.
- Data in animals and humans indicate that intravenous administration of Zn-DTPA forms chelates with radioactive contaminants found in the circulation, interstitial fluid, and tissues. When administered by inhalation, Zn-DTPA can also chelate transuranium elements.
- Expectoration is expected to decrease the amount of radioactive contaminants available for systemic absorption.
- The effectiveness of chelation treatment decreases with time after internal contamination because the transuranium elements become incorporated into the tissues. Chelation treatment should be given as soon as possible after known or suspected internal contamination with transuranium elements has occurred.
- When the sources of radiation contamination are multiple or unknown, other therapies (such as potassium iodide, insoluble Prussian blue) can be used together with Zn-DTPA.30698
