RADIOGARDASE(Heyl Chem.-pharm. Fabrik GmbH & Co. KG)(六)
ian blue insoluble. Severity of constipation was mild in 7 patients and moderate in 3 patients. Constipation was successfully treated with a high fiber diet.
Undefined gastric distress was reported in 3 patients treated with 20 gram/day of Prussian blue insoluble. In these patients the dose was reduced to 10 gram/day for continued treatment.
OVERDOSAGEThe clinical effects of overdosing with Prussian blue insoluble are not known. Based on reported adverse events and mechanism of action, possible overdose symptoms may include obstipation, obstruction, or severe decrease in electrolytes.
DOSAGE AND ADMINISTRATIONAdults and AdolescentsThe recomme nded dose of Prussian blue insoluble is 3 grams orally three times a day.
Pediatrics (2 – 12 years)
The recommended dose of Prussian blue insoluble is 1 gram orally three times a day.
In patients who cannot tolerate swallowing large numbers of capsules, the capsules may be opened and mixed with bland food or liquids. This may result in blue discoloration of the mouth and teeth.
Prussian blue insoluble capsules may be taken with food to stimulate excretion of cesium or thallium.
Treatment with Prussian blue insoluble for radioactive cesium (137Cs) contamination
Treatment with Prussian blue insoluble should be initiated as soon as possible after contamination is suspected. Contamination should be verified as soon as possible. However, even when treatment cannot be started right away, patients should be given Prussian blue insoluble as soon as it becomes available. Treatment with Prussian blue insoluble is still effective even after time has elapsed since exposure.
Treatment should continue for a minimum of 30 days and then the patient should be reassessed for the amount of residual whole body radioactivity. The duration of treatment after exposure is dictated by the level of contamination and the judgment of the attending physician. Before, during and after therapy, pertinent measurements for radioactivity should be made to help determine when to terminate treatment.
During treatment, the following information should be collected:
◦the radioactivity counts in urine and fecal samples should be measured and recorded weekly to monitor 137 Cs elimination rate, and
◦the occurrence of any adverse events from Prussian blue insoluble (i.e., constipation, which can be treated by increasing the amount of fiber in the diet).
When the internal radioactivity is substantially decreased, the Prussian blue insoluble dose may be decreased to 1 or 2 grams TID to improve gastrointestinal tolerance.
Treatment with Prussian blue insoluble for thallium contamination
Treatment with Prussian blue insoluble should be initiated as soon as possible after contamination is suspected. Contamination should be verified as soon as possible. However, even when treatment cannot be started right away, treatment with Prussian blue insoluble is effective and should not be withheld.
Further considerations for radioactive cesium contamination
1.Health professionals should follow appropriate radiation protective attire and procedures at all times. Protect health professionals handling patients from unnecessary radiation exposure and monitor health professionals and the area of operation for radiation levels, using radiation detection, indication, and computation devices (RADIAC) or thermal luminescent devices (TLD).
Control spread of radiation contamination through th |
