70.

Sidbury Jr. JB. Lead poisoning, treatment with disodium calcium ethylenediamine-tetraacetate. Am J Med. 1955; 18:932-946 (June). (1622) [The mechanism of action of EDTA in Pb poisoning and its pharmacologic properties are described. The results of treatment of 9 patients with Pb poisoning (1 child, the others adult) indicated that CaNa2EDTA is superior to previous modes of therapy. Pb poisoning was established by history, physical examination and laboratory findings, including determination of the Pb content of blood and urine. Dosage for adults by iv route was 1 g on 1st day, 2 g/day thereafter for a total of 5 days, in divided doses twice/day in 250 ml 5% glucose. For children, 30 mg/kg twice daily. Oral administration for both children and adults was 30 mg/kg body weight before breakfast and supper with liberal amounts of water. The 2nd plan called for 0.4 g EDTA diluted to 5 or 10 ml with saline iv once or twice daily, either as outpatients or in the hospital, depending on the severity of disease. Symptoms were relieved and a marked increase in the urinary excretion of Pb was effected. A suggested dosage regimen which is convenient for administration in the doctor's office or in the plant dispensary is presented. The different routes of administration and their limitations are discussed. No toxic reactions have been encountered from the use of EDTA in >35 patients. The role of internist and the general practitioner in the diagnosis and treatment of Pb poisoning is emphasized. The importance of early recognition is accentuated by the availability of an effective agent for treatment which, it is believed, will prevent the permanent sequelae of Pb poisoning if appropriate therapy is instituted early.

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