Pharmacology. Diethylenetriaminepentaacetate (Zn-DTPA and Ca-DTPA) is a chelating agent that is used in exposures to the transuranic elements plutonium, americium, and curium. DTPA is used as a salt of calcium or zinc and forms a chelate that is excreted in the urine. DTPA has a plasma half-life of 20–60 minutes and is distributed in the extracellular space. It has a small amount of protein binding and does not undergo significant metabolism or tissue accumulation. Ca-DTPA resulted in a 10-fold higher rate of elimination of plutonium compared with Zn-DTPA, so this salt is preferred in initial patient management if available.

Indications. Internal contamination with plutonium, americium, or curium. It has also been used for treatment of internal contamination with californium and berkelium.

Contraindications

1. 
   

   Known hypersensitivity to the agent.

   
   
2. 
   

   DTPA should not be used in uranium or neptunium exposures because it may increase bone deposition of these elements.

   
   
3. 
   

   Ca-DTPA should not be used in patients with renal failure, nephrotic syndrome, or bone marrow suppression, or in those who are pregnant.

Adverse effects

1. 
   

   Nausea, vomiting, and diarrhea.

   
   
2. 
   

   Fever, chills, and myalgias.

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