Calcium Trisodium Glutamate Injection (Ditripentat-HeylAmp.) is a metal chelating agent, primarily used for the treatment of internal contamination by transuranic elements such as plutonium (Pu), americium (Am), or curium (Cm).
How to Use Calcium Trisodium Glutamate Injection (Ditripentat-HeylAmp.)
Indications and Administration Timing
Indications: Indicated for the emergency treatment of known or suspected internal contamination with plutonium, americium, or curium.
Key Principle: Treatment should be initiated within 24 hours after contamination, as this is when the chelating effect is optimal; however, even if delayed, administration as soon as possible is still recommended.
Administration Regimen
Initial Dose: A single intravenous injection of 1.0 gram (5mL of solution).
Maintenance Treatment: On the following day, priority should be given to switching to zinc-DTPA (Zn-DTPA). If Zn-DTPA is unavailable, continue treatment with Ca-DTPA at a daily dose of 1.0 gram via intravenous injection.
Intravenous Injection Procedure
The solution can be administered by direct slow intravenous push (over 3-4 minutes) or infused after dilution in 100-250mL of 5% glucose injection/normal saline.
Before use, check whether the solution is clear; filter if necessary.
Inhalation Administration (Limited to Within 24 Hours of Inhalational Contamination)
Method: Dilute Ca-DTPA with sterile water/normal saline at a 1:1 ratio, then administer via nebulization for inhalation.
Caution: May induce asthma or cough; respiratory responses need to be monitored.
Dose Adjustment of Calcium Trisodium Glutamate Injection (Ditripentat-HeylAmp.)
Circumstances Requiring Dose Adjustment
Children (<12 years old): A single initial dose of 14mg/kg (maximum 1.0 gram); the maintenance dose is the same as the initial dose.
Renal Impairment: No dose adjustment is required, but chelating efficiency may decrease. For patients with severe renal impairment, combined dialysis treatment may be considered.
Contraindications and Precautions for Calcium Trisodium Glutamate Injection (Ditripentat-HeylAmp.)
Absolute Contraindications: Patients with a history of allergy to Ca-DTPA or any of its excipients.
Precautions for Use:
Severe hemochromatosis.
Asthmatic patients (inhalation administration may exacerbate symptoms).
Medication for Special Populations of Calcium Trisodium Glutamate Injection (Ditripentat-HeylAmp.)
Pediatric Patients
Intravenous Administration: Efficacy is extrapolated from adult data; doses are adjusted based on body weight.
Inhalation Administration: Efficacy in the pediatric population has not been established; avoid use.
Pregnancy and Lactation
Pregnancy: Animal studies have shown teratogenicity. Administration should be limited to a single dose only in high-risk situations, and zinc supplements should be given concurrently.
Lactation: Radioactive contaminants can pass into breast milk; breastfeeding must be discontinued.
Geriatric Patients
No dose adjustment is required, but enhanced monitoring of renal function and trace element levels is necessary.
