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All about: Edetate Disodium (EDTA)

Big Image ( EDTA ) Pronouncation: (EH-duh-tate die-SO-dee-uhm)
Class: Cardiovascular agent

Trade Names:
Endrate
- Injection 150 mg/mL

Mechanism of Action

Pharmacology

Forms chelates with polyvalent metals, especially calcium, thus increasing their urinary excretion.

Pharmacokinetics

Elimination

The chelate formed is excreted in the urine.

Indications and Usage

Emergency treatment of hypercalcemia; control of ventricular arrhythmias associated with digitalis toxicity.

Contraindications

Anuria.

Dosage and Administration

Adults

IV 50 mg/kg/day (max 3 g/day). Usually administered in 5 consecutive daily doses followed by 2 days without medication, with repeated courses as needed, for total of 15 doses.

Dissolve 50 mg/kg dose in 500 mL of D5W or sodium chloride 0.9% for injection. Infuse over 3 h or more.

Children

IV 40 mg/kg/day (max 70 mg/kg/day) or 15 to 50 mg/kg/day (max 3 g/day) with 5 days between courses.

Dissolve drug in sufficient volume of D5W or sodium chloride 0.9% for injection to bring final concentration to 3% or less. Infuse over 3 h or more.

General Advice

Do not confuse edetate disodium with edetate calcium disodium.

Storage/Stability

Store at room temperature.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Transient drop in BP; adverse reactions on myocardial contractility; thrombophlebitis.

CNS

Transient circumoral paresthesia; numbness; headache.

Dermatologic

Exfoliative dermatitis; toxic skin and mucous membrane reactions.

GI

Nausea; vomiting; diarrhea.

Genitourinary

Nephrotoxicity; damage to reticuloendothelial system.

Hematologic

Thrombophlebitis; anemia.

Metabolic

Electrolyte imbalances including hypocalcemia, hypokalemia, and hypomagnesemia; hyperuricemia.

Miscellaneous

Febrile reactions.

Precautions

Monitor

Hypocalcemia

If signs or symptoms of hypocalcemia occur (eg, circumoral numbness/tingling, positive Chvostek's or Trousseau's signs, tetany), notify health care provider.


Pregnancy

Category C .

Lactation

Undetermined.

Special Risk Patients

Use drug cautiously in patients with limited cardiac reserve or incipient congestive failure.

Diabetic patients

Blood sugar and insulin requirements may be lower in insulin-dependent diabetic patients.

Hydration

Adequately hydrate patient before administration.

IV infusion

Rapid IV infusion or high serum concentrations can cause a precipitous and potentially fatal drop in serum calcium. Do not exceed maximum dose or rate.

Overdosage

Symptoms

Drop in serum calcium.

Patient Information

  • Advise patient to remain recumbent for 30 min after infusion because of possibility of orthostatic hypotension.
  • Inform patient that breath may be odorous.

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