BAL | DMPS | CaNa2EDTA | DMSA | |
---|---|---|---|---|
Amendable to EBP | + | ++ | +++ | + / - |
Molecular Weight (Dalton) | 124 | 228 | 374 | 182 |
Chelate-Pb Complex MW (Dalton) a | 331 (455 if ratio is 2:1) [3] | 434 | 540 | 389 |
Chelate-Ars Complex MW (Dalton) a | 199 (323 if ratio is 2:1) [3] | 303 (803 if ratio is 3:2) [4] | Cannot chelate arsenic [16] | 257 |
Administration Route | IM in peanut oil medium | PO, IV | IV, IP, IM | PO |
Distribution | Lipophilic | Hydrophilic | Hydrophilic | Hydrophilic |
Volume of Distribution | High | 0.16 L/kg [4] | 0.21 L/kg [17] | 0.4 L/kg b [18] |
Protein Binding | n/a | 62.5% [19] | 11 – 19% [20] | 95% [21] |
Excretion | Renal (Major) | Renal (46 – 59%) Biliary (extent undetermined) | Renal (Major) | Renal (Major) |
LD50 (mmol/kg) | 1.48 c [16] | 6.53 c [16] | 16.4 [5] | 13.73 c [16] |
Contraindications | Peanut allergies, hepatic dysfunction, methylmercury poisoning | None in acute lead or arsenic toxicity | None in acute lead toxicity | None in acute lead or arsenic toxicity |
Adverse Effects | Nausea, vomiting, headache, hypertension, pain and/or sterile abscess at injection site, haemolysis in G6PD-deficiency, chelation of essential metals in prolonged use | Allergic reaction, nausea, vomiting, Steven-Johnson syndrome (rare) | Fatigue, headache, mild AST/ALT elevations, nephrotoxicity, chelation of essential metals in prolonged use | Nausea, vomiting, diarrhoea, mild AST/ALT elevations, Fever, rash, reversible neutropenia (rare), chelation of essential metals in prolonged use |