1550 Chelators Antidotes and
started first since sodium calcium edetate may cause distributed but is concentrated in the kidney, liver, and Profile mobilisation of stored lead in symptomatic toxicity. A small intestine. Dimercaprol is rapidly metabolised and the suggested regimen is to give dimercaprol intramuscularly in metabolites and dimercaprol-metal chelates are excreted in Ditiocarb sodium is a chelator that has been used in nickel an initial dose of 4 mg/kg, followed at 4-hourly intervals by the urine and bile. Elimination is essentially complete carbonyl poisoning. Disulfiram (p. 2495.3), which is rapidly dimercaprol 3 to 4mg/kg intramuscularly and sodium within 4 hours of a single dose. metabolised to ditiocarb, has been used as an alternative. calcium edetate; the sodium calcium edetate may be given Ditiocarb has also been used in the destruction of cisplatin either intravenously, or intramuscularly at a different site Preparations wastes (see Handling and Disposal. p. 768.2). from the dimercaprol. Treatment may be continued for 2 to ...... 7 days depending on the clinical response; in patients with Proprietary Preparations (details are given in Volume B) lead encephalopathy, combined therapy should be Edetic Acid (BAN, fiNN) Single-ingredient Preparations. Rus.: Zorex (30peKC). continued until the patient is stable. In severe lead Acide. Ed~tiqLie:AcidoedeticoiAcido. etilendiarni!'lotetraa poisoning, a minimum of 2 days without treatment should Mulfi·ingredient Preparatio·ns. Ukr.: Zarex (30peKc). cetieo; •• Acido .. Etilefldiafl'\minqtetraac:etico;Acidum. Edeti elapse before a second course of therapy with either C1.jm; Edathamil;Edetico; aCido;EdetHniha,ppo;. Edetinsaure; combined dimercaprol and sodium calcium edetate or Pharmacopoeial Preparations sodium calcium edetate alone is considered. BP 2014: Dimercaprol Injection; Edetinsyra; Edeto rOgstis;. EDTA;> Ethyle"ndfamfnetetra USP 36: Dimercaprol Injection. azijnzuur;. Ethylendiamintetraessigsaure; .• Etilendiamintetrae Administration in children. Dimercaprol has been used in cetsav; Etilen-dfamin-tetraecetsw; .Kwas edetynoyvy; Kyselina children in the treatment of acute poisoning by heavy edetova; Tetracemic Acid; 3geToBaRK"cnota. metals such as arsenic, gold, mercury, antimony, and bis 4-Dimethylaminophenol Hydrochloride Ethylenediaminetetra-acetic.ilCid. muth. It can also be used with sodium calcium edetate for ClOH SN,Os=292.2 Oimetarnfel1ot Hydrochloride;4-DlrnetHaminsfenol,. hidro ' acute lead poisoning. After the second or third injection of C4S - 60:00-4, cloruro de; 4-DMAP; 4-,[\MMeTYInaMt4Ho(jIeHona dimercaprol. about 30% of children develop a [ever that UN/I ~ 9G34HWRVO. may persist until treatment is stopped. Doses are the rt4APOXnop~A. equivalent per unit body-weight to those used in adults, C8Hll NO,HCI,cc173.6 .chelation therapy with dimercaprol and sodium calcium almost white crystalline powder. Sparingly soluble in water; Soluble in water. pH of a 5 % solution in water is between edetate for high blood-lead concentrations in 2 children slightly soluble in alcohol; very slightly soluble in 4.0 and 6.0. with a deficiency of G6PD. chloroform; practically insoluble in ether. A 2% solution 1. Janakiraman N, et al. Hemolysis during BAL chelation therapy for high in water has a pH of 4.5 to 6.0. Protect from light. Trisodium Edetate blood lead levels in two G6PD deficient children. Clin Pediatr (Phila) 1978; 17: 485-7. EdetateTrisodium (U5AN);. Edemo tris6dico. Profile Trisodium.hydrogene)h~lenediaminetetra-acetate .. Pregnancy. Although data are scarce, there are reports of Diprenorphine hydrochloride is an opioid antagonist used CIDHJ3 N,N!l,08=358.2 . the use of dimercaprol for poisoning in the second or third as a radioligand in positron -emission tomography to image CAS. cc-l.50-38-9. trimester of pregnancy, without apparent adverse effects opiate receptors. It is also used in veterinary medicine to AIC'-,.SQ1XAOS. on the neonate.1,2 reverse the effects of etorphine hydrochloride. ATe Vet-'-QSO./XA05. 1. Shannon M. Severe lead poisoning in pregnancy. Ambul Pediatr 2003; 3: UNJ/"-c 4201P927MB. 37-9. 2. Bailey B. Are there teratogenic risks associated with antidotes used in the acute management of poisoned pregnant women? Birth Defects Res A Ditiocarb Sodium (rlNN) Tetrasodium Edetate Clin Mol Terato12003; 67: 133-40. ODC;· DDTC:.·OEDC; •. DeDTC;pithiscarqi'o.dium; .•. D.itiocarb" Interactions 5sdique;. Ditio~arbo s6di~o;~itiocarbwm.· Natrf,um; ·DTC; SSdiU~ •.. Dl~thyldit~fs~arbamate; $odu .. dietyloditiokarbami- Iron supplements should not be given during dimercaprol ~ran; U:)4624;):\"T~OKap6 HaTpt4~. . therapy as the dimercaprol-iron complex formed is toxic. C5HlDNNaS2~.171.3 CAS -'-148-18'5.. Pharmacokinetics UN/I '--- AS304YE85E. After intramuscular injection, peak plasma concentrations NOTE. The code DDC has also been used as a synonym for Incompatibility. Edetic acid and its salts chelate bivalent of dimercaprol occur within 30 to 60 minutes. It is widely Zalcitabine, p. 1023.2. and trivalent metals and may affect the activity of drugs
All cross-references refer to entries in Volume A