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Diethylenetriaminepentaacetate
(DTPA) can remove certain radioactive materials from people’s
bodies, but it must be taken under the guidance of the Radiation
Emergency Assistance Center/Training Site (REAC/TS) of the Oak Ridge
Institute.
People
may become internally contaminated (inside their bodies) with radioactive
materials by accidentally ingesting (eating or drinking) or inhaling
(breathing) them. The sooner that these materials are removed from
the body, the fewer and less severe the health effects of the contamination
will be. DTPA currently is available to help remove these materials
when doctors have determined that a person is internally contaminated.
What
DTPA Is
DTPA is a calcium or zinc salt that has been used for more than 40 years to
perform medical imaging of the brain, kidneys, and lungs.
Use
of DTPA to Treat Radioactive Contamination
Since the 1960s, doctors have successfully used DTPA to treat people who have
been internally contaminated with certain radioactive materials, such as americium,
plutonium, californium, curium, and berkelium. With special permission from
the U.S. Food and Drug Administration (FDA), DTPA also may be used to treat
people who have been internally contaminated with the following radioactive
materials: cerium, yttrium, lanthanum, promethium, scandium, zirconium, and
niobium.
How
DTPA Works
DTPA comes in two forms: calcium (Ca-DTPA) and zinc (Zn-DTPA). Both forms are
capable of binding to certain radioactive materials (refer to previous section)
and speeding up the release of these materials in the urine, thus reducing
the amount of internal contamination.
Who
Can Take DTPA
People may be prescribed DTPA during an emergency when radioactive materials,
such as plutonium or americium, have entered their bodies. Because DTPA is
approved only for limited use, it must be taken under the guidance of REAC/TS.
Ca-DTPA
is safe for most adults, but it should not be taken by
people who have kidney disease or bone marrow depression. Also, Ca-DTPA
should not be taken by children younger than 18 years of age,
by pregnant women, or by people who have bone marrow problems. Children
and pregnant women who are under a doctor’s care can take small
doses of Zn-DTPA. Ca-DTPA and Zn-DTPA should not be used to
treat people who are internally contaminated with the radioactive materials
uranium or neptunium.
Side
effects of DTPA
Most DTPA is excreted (released) in the urine within 12 hours after it is given,
so it does not build up in the body or cause long-term health effects. Side
effects of treatment with DTPA can include nausea, vomiting, diarrhea, chills,
fever, itching skin, and muscle cramps, but these symptoms decrease between
treatments. Also, although DTPA increases the loss of the mineral zinc from
the body, zinc supplements can be taken to offset this loss.
How
DTPA Is Given
DTPA can be injected into a vein in the arm over a 2-hour period in a slow
drip of liquid from a bag or over a 3- to 5-minute period using a syringe.
When neither of these methods is possible, DTPA can be injected into the muscle.
However, injecting DTPA into muscle causes significant pain in the area of
the injection.
What
The Treatment Plan Is
Because Ca-DTPA causes the body to lose some necessary minerals, such as zinc
and magnesium, people usually are given Ca-DTPA only during the first several
days of the treatment. During these first several days, doctors collect urine
and blood samples from the people who are undergoing treatment. The urine and
blood samples provide information about levels of radioactive materials in
the body. Zn-DTPA is used after the first several days, because it does not
cause the body to lose minerals as quickly.
DTPA may
need to be administered as often as 5 days a week for a period of several
years to ensure that the body excretes as much radioactive material
as possible.
Where
You Can Get DTPA
DTPA
for the treatment of internal radioactive contamination is not routinely
available. When approved for use by REAC/TS, it is shipped to a doctor
who will administer it.
Where
You Can Get More Information
More detailed information on DTPA can be found at the REAC/TS web pages on
Zn-DTPA and Ca-DTPA.
The FDA
web site also offers information.
You can
also call the CDC Public Response line at 1-800-311-3435 or visit the web
site to request more information
The
Centers for Disease Control and Prevention (CDC) protects people's health
and safety by preventing and controlling diseases and injuries; enhances
health decisions by providing credible information on critical health
issues; and promotes healthy living through strong partnerships with
local, national, and international organizations.
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