Zinc DTPA & Calcium DTPA
Doctors and public health authorities will work together to decide who likely will benefit from DTPA treatment.
For doctors who may be administering DTPA for patients, use the following guidelines:
- Infants (including breastfed infants) and children less than 12 years of age can be given either Ca-DTPA or Zn-DTPA.
- The dosage of DTPA should be based on the child’s size and weight.
- The safety and effectiveness of the inhaled route of DTPA has not been studied in children.
- Young adults and adults internally contaminated with plutonium, americium, or curium should receive Ca-DTPA if treated within the first 24 hours after contamination. After 24 hours, if additional treatment is needed, adults should receive Zn-DTPA. If Zn-DTPA is not available, patients may receive Ca-DTPA together with a vitamin and mineral supplement that contains zinc.
- Pregnant women should be treated with Zn-DTPA, unless the woman has very high levels of internal contamination with plutonium, americium, or curium.
- Ca-DTPA should be used in pregnant women only to treat very high levels of internal radioactive contamination.
- In this case, doctors and public health authorities may prescribe a single dose of Ca-DTPA, together with a vitamin and mineral supplement that contains zinc, as the first treatment.
- After the first dose of Ca-DTPA, treatment should continue 24 hours later with a daily dose of Zn-DTPA, as needed.
- Breastfeeding women who are internally contaminated with plutonium, americium, or curium can be treated with Ca-DTPA or Zn-DTPA.
- Inhaling DTPA might cause some people, especially those with asthma, to cough or wheeze.
- The safety and effectiveness of inhaled DTPA has not been shown in children.
- The amount of radioactive material in your body
- How well your body gets rid of the radioactive material with the help of DTPA.
Ca-DTPA and Zn-DTPA should not be administered simultaneously. FDA recommends that, if both products are available, Ca-DTPA be given as the first dose. If additional treatment is needed, treatment should be switched to Zn-DTPA. 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 loss of essential metals, such as zinc, from the body. Therefore, Zn-DTPA is preferred for maintenance therapy.
- If Ca-DTPA is not available or treatment cannot be started within the first 24 hours after contamination, treatment should begin with Zn-DTPA.
- If Zn-DTPA is not available, Ca-DTPA can be given for continued treatment, along with vitamin or mineral supplements that contain zinc.
- Ca-DTPA and Zn-DTPA can be administered by nebulizer or directly into the blood stream (i.e. intravenously). If the route of internal contamination is through inhalation alone, then nebulized chelation therapy will suffice. If the routes of contamination are multiple (e.g., inhalation and through wounds), then intravenous chelation therapy is preferred.
- The duration of treatment is dictated by the level of internal contamination and the individual’s response to therapy. Levels of internal contamination should be ascertained weekly during chelation therapy to determine when to terminate treatment.
- Zn-DTPA is the preferred treatment for the pregnant woman with internal contamination.
- Military bases that may be exposed to Plutonium.
- Hospitals that may have a risk of dealing with dirty bomb victims.
- Hospital facility that is a designated Plutonium treatment center or might treat patients from a Nuclear Reactor.
- Other facilities that want to be prepared for similar occurrences.