TABLE 102.16 GUIDELINES FOR CHELATION THERAPY OF LEAD POISONING Condition, BLL Regimen a Comment Encephalopathy BAL 450 mg/m2 /day + 75 mg/m2 IM every hrs for days Continuous infusion, or 2–4 divided IV doses, for days (start hrs after BAL) 50–75 mg/m2 every hrs for 3–5 days (see text) Continuous infusion, or 2–4 divided IV doses, for days (start hrs after BAL) 350 mg/m2 TID for days, then BID for 14 days CaNa2 EDTA 1,500 mg/m2 /day Symptomatic, BAL 300–450 mg/m2 /day and/or BLL >70 CaNa2 EDTA 1,000–1,500 mg/m2 /day Asymptomatic, BLL 45–69 Succimer 700–1,050 mg/m2 /day or CaNa2 EDTA, 1,000 mg/m2 Continuous infusion, or 2–4 divided IV doses, for /day days a Doses expressed in mg/kg: BAL 450 mg/m2 (24 mg/kg), 300 mg/m2 (18 mg/kg); CaNa2 EDTA 1,000 mg/m2 (25–50 mg/kg), 1,500 mg/m2 (50–75 mg/kg); Succimer 350 mg/m2 (10 mg/kg) BLL, blood lead level (mcg/dL); BAL, British Anti-Lewisite; IM, intramuscular; IV, intravenous Adapted from American Academy of Pediatrics, Committee on Drugs Treatment guidelines for lead exposure in children Pediatrics 1995;1996:155–160; Henretig FM Lead In: Goldfrank LR, Flomenbaum NE, Lewin NA, et al., eds Goldfrank’s Toxicologic Emergencies 9th ed New York: McGraw-Hill; 2009 Pesticides CLINICAL PEARLS