How is the chelator DTPA administered for treatment of internal contamination with radioactive plutonium, americium, or curium?
DTPA, or diethylenetriamine pentaacetate, is supplied as Ca-DTPA or Zn-DTPA. Administration is intravenous, or via inhalation by nebulization, depending on many variables such as route of contamination.
Existing publications and references state that Ca-DTPA is more effective in early (first 24 hours) decorporation of contamination and is recommended for the initial dose, but can deplete magnesium and trace elements. Zn-DTPA is recommended if Ca-DTPA cannot be started within 24 hours, for subsequent daily maintenance dosing, and for pregnant patients or children. If Zn-DTPA is not available, Ca-DTPA can be given for continued treatment, along with vitamin or mineral supplements that contain zinc.
Contributor: Dr. Mark Layer, MD, Emory University on behalf of the Radiation Section
Keenan M, Behrens T, Bravenec S, et al. Americium Inhalational Exposure with Successful Chelation Therapy. Disaster Med Public Health Prep. 2021 Aug 17;1-5. doi: 10.1017/dmp.2021.211