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Ethylenediaminetetraacetic acid (EDTA) is a medication used in the management and treatment of heavy metal toxicity. It is in the chelating class of drugs. This activity outlines and reviews the indications, actions, and contraindications for EDTA as a valuable agent in managing lead toxicity. This activity will highlight the mechanism of action, side effect profile, and other key factors such as dosing, pharmacokinetics, and monitoring pertinent for members of the healthcare team in the use of EDTA. Objectives: Outline the indications for EDTA. Identify the most common adverse effects associated with EDTA therapy. Explain the importance of monitoring for patients on EDTA therapy, including renal function tests. Identify the mechanism of action of EDTA. Access free multiple choice questions on this topic.

Currently, no antidotes are available for EDTA. In patients who have cerebral edema, increases in intracranial pressure should be treated immediately with osmotic agents. Patients with nephrotoxicity should be given fluids to ensure hydration and be monitored for urine output. Renal function should be continuously monitored even after the development of toxicity. Overall, patients who develop signs or symptoms of toxicity should immediately be discontinued from the drug.

Heavy metal toxicity is a major concern in both adult and pediatric populations. This is of special concern to the pediatric population as lead poisoning can affect cognition and neurodevelopment. Due to the permanent toxic effects of heavy metals, patients must be treated quickly and appropriately. Adequate management by a team of healthcare professionals plays an important role in decreasing overall morbidity and mortality associated with metal toxicity. Healthcare providers involved in the care of a patient being treated with EDTA should be knowledgeable about the pharmacology and adverse effects of the drug. EDTA has the ability to bind various minerals within the body and should be monitored for any adverse effects. Pharmacists should be mindful of the important difference between edetate disodium and calcium disodium edetate to prevent life-threatening hypocalcemia. Nurses should verify dosing and administration with the pharmacy team and understand the adverse drug reactions mentioned to inform the managing healthcare provider promptly. [Level 5] Clinicians should be aware of the well-known renal toxicity associated with EDTA. Patients with current renal dysfunction or disease should be monitored carefully or moved to a different chelation agent. Social workers can help the family identify any occupational or home exposure to heavy metals and assist in preventing further exposure. Each member of the interprofessional healthcare team has an important role in treating a patient with EDTA and can significantly reduce the morbidity and mortality associated with heavy metal toxicity.