pentetate calcium trisodium

Contraindicated in:

Lactation: Lactation.

Use Cautiously in:

Renal impairment;
Severe hemochromatosis;
Asthma (inhalation only);
Mixed radiocontamination (additional treatments may be needed);
OB: Pregnancy (use pentetate zinc trisodium unless contamination is high);
Pedi: Children (safety of inhalation not established).

Adv. Reactions/Side Effects ⬆ ⬇

CV: chest pain

Derm: dermatitis

GI: diarrhea, metallic taste, nausea

F and E: depletion of zinc, manganese, magnesium (prolonged treatment)

Local: injection site reactions

Neuro: headache, light-headedness

Resp: cough, wheezing (inhalation only)

Misc: allergic reactions

Interactions ⬆ ⬇

Drug-drug:

None reported.

Availability ⬆ ⬇

Solution for injection or inhalation: 200 mg/mL

Route/Dosage ⬆ ⬇

Pentetate calcium trisodium is more effective than pentetate zinc trisodium and should be given as the initial dose in the first 24 hr following internal contamination. After 24 hr, pentetate zinc trisodium is equally effective.

IV (Adults and Children ≥12 yr): 1 g as a single dose; then follow with pentetate zinc trisodium. If pentetate zinc trisodium is unavailable, continue with pentetate calcium trisodium 1 g once daily. Duration of treatment depends on degree of contamination and response.
IV (Children <12 yr): 14 mg/kg as a single dose (max = 1 g/dose); then follow with pentetate zinc trisodium. If pentetate zinc trisodium is unavailable, continue with pentetate calcium trisodium 14 mg/kg once daily. Duration of treatment depends on degree of contamination and response.
Inhaln (Adults ): 1 g as a single dose; then follow with pentetate zinc trisodium. If pentetate zinc trisodium is unavailable, continue with pentetate calcium trisodium 1 g once daily. Duration of treatment depends on degree of contamination and response.

Action ⬆ ⬇

Forms chelates by exchanging for metals with a greater binding ability (radioactive plutonium, americium, or curium). These chelates are then renally excreted.

Therapeutic effects:

Increased rate of removal of radioactive compounds from the body with decreased sequelae of radiation exposure.

Classifications ⬆ ⬇

Therapeutic Classification: radiation protectants

Pharmacologic Classification: chelating agents

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability. 20% absorbed following inhalation.

Distribution: Rapidly distributed into extracellular fluid space.

Metabolism/Excretion: Excreted by glomerular filtration. <3% eliminated in feces.

Half-Life: 94 min.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
IV	rapid	unknown	24 hr

Patient/Family Teaching ⬆ ⬇

Instruct patient to drink plenty of fluids and void frequently to promote dilution of the radioactive chelate in the urine and minimize radiation exposure directly to the bladder. When possible, patients should use a toilet instead of a urinal and flush several times after each use.
Advise patient and parents to clean up spilled urine or feces completely and wash hands thoroughly. If blood or urine comes in contact with clothing or linens, wash items separate from other laundry.
Caution patients who are coughing to dispose of expectorant carefully.

section name header

Indications ⬇

Contraind./Precautions ⬆ ⬇