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Medical Information about Ca-DTPA
Active Pharmaceutical Ingredient: Calcium-trisodium-pentetate
Brand Name: Ditripentat-Heyl® (DTPA)
ATC-Code: V03AB47 pentetic acid
Dosage form: Solution for injection for intravenous use
Indications:
Mechanism of Action:
Ca-DTPA binds to radioactive isotopes of the indicated elements, facilitating their excretion. By releasing calcium ions, DTPA forms stable complexes with the nuclides, which are excreted in the urine via the kidneys. Thereby the duration the radioactive nuclides that remain in the body is reduced. In this way, DTPA helps minimize the body’s exposure to radiation. For acute poisoning, initiation of treatment with the more potent Ca-DTPA is recommended. Long-term treatment should then be continued with the less toxic Zn-DTPA.
Recommended dosage:
Treatment of poisoning requires individual dosage, depending on the symptoms of intoxication.
Recommended regimen:
Possible transition to Zn-DTPA for long-term therapy after the first phase of treatment.
Important Notes:
Patients exposed to high levels of radionuclides, such as americium or plutonium, may experience bone marrow suppression. This can result in neutropenia and thrombocytopenia, necessitating additional supportive care alongside DTPA treatment.
Essential Trace Element Depletion
DTPA increases the excretion of some trace elements particularly of zinc. In individual cases with
long-term treatment clinically manifest zinc deficiency was described (alopecia, skin reactions,
mucosa changes [exanthemas, enanthemas]). The symptoms were reversible after the
supplementation of zinc. The increased zinc excretion is presumably also the main cause for other side effects. So kidney lesions, intestine disturbances and bone marrow damages (thrombocytopenia) are described at Ca-DTPA therapy. At lack of minerals the appropriate trace elements must be substituted.
Pregnancy Warning
Ca-DTPA is teratogenic and should not be used during pregnancy. In such cases, Zn-DTPA is the preferred treatment due to its safer profile.
Nephrotoxicity
DTPA can lead to kidney damages (nephrotic syndrome and renal insufficiency). Ca-DTPA is contraindicated in patients with renal insufficiency due to the risk of nephrotoxicity. Regular monitoring of kidney function is recommended during treatment.
At repeated administrations of Ca-DTPA with too short regeneration intervals between the single
ones, the following symptoms may occur: Delayed fever reaction, nausea, vomiting, diarrhoea,
shiver, headaches, itching (pruritus), muscular cramps
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