Effective strategies to decrease morbidity from accidental radiation exposure includes all except
Answer: b) Ranitidine therapy for barium ingestion.TREATMENT OF RADIONUCLIDE CONTAMINATIONTreatment for internal radionuclide contamination, also referred to as decorporation, should be started as soon as possible after suspected or known exposure.The goal is to leave the smallest amount of radionuclides possible in the body.Treatment is given to reduce absorption and enhance elimination and excretion.Clearance of the Gl tract may be achieved by stomach lavage, with emetics (such as apomorphine, 5 to 10 mg, or ipecac, 1- to 2-g capsules or 15 mL in syrup), or by using purgatives, laxatives, ion exchangers, and aluminum antacids.Prussian blue: to treat cesium 137 internal contamination.Aluminum antacids: to reduce strontium uptake in the gut.Prevention or reversal of radionuclide interaction with tissues by blocking, diluting, mobilizing, and chelating agents.Blocking agents prevent the entrance of radioactive materials.Potassium iodide (Kl), which blocks the uptake of radioactive iodine (131l) by the thyroid. Other thyroid-blocking agents include prophylthiouracil, methimazole.Diluting agents decrease the absorption of the radionuclide.Water may be used as a diluting agent in the treatment for tritium (3H) contamination and for barium overdosage.Mobilizing agents are most effective when given immediately.These agents include antithyroid drugs, parathyroid extract, glucocorticoids, ammonium chloride, diuretics, expectorants, and inhalants.All of them should induce the release of radionuclides from tissues.Chelating agents can bind many radioactive materials, after which the complexes are excreted from the human body.DTPA was approved to treat internal contamination with plutonium, americium, and curium, but it also chelates berkelium, californium, and any material with an atomic number >92.Ca-DTPA is more effective than Zn-DTPA during the first 24 hours after internal contamination, and both drugs are equally effective after the initial 24 hours.If both drugs are available, Ca-DTPA should be given as the first dose.Nebulized Zn-DTPA is recommended if the internal contamination is only by inhalation.The IV route is recommended and should be used if the route of internal contamination is not known or if multiple routes of internal contamination are likely.Treating uranium contamination with DTPA is contraindicated due to its synergistic damage to the kidneys.Lung lavage can reduce radiation-induced pneumonitis and is indicated only when a large amount of radionuclide enters the lungs and has the potential for acute radiation injury.The procedure requires anesthesia.Common Drugs for Treatment of Internal ContaminationMedicationAdministered for RadionuclidesRoute of AdministrationMechanism of ActionKl131IPOBlocking agentZn-DTPA Ca- DTPAPlutonium, trans-plutonium, yttrium, americium, curiumIV, IM, InhalationChelating agentBicarbonateUraniumIV, POIncreased excretion via kidneysPrussian blueCesium-137POIon exchangerWaterTritium (H-3)POExcretion of waterAluminum phosphate gelStrontiumPODecreased gut absorptionAluminum hydroxide PODecreased gut absorptionExcluding Kl & Prussian blue, these drugs have not been approved for this purpose.
Dilution therapy in tritium exposure
Ranitidine therapy for barium ingestion
Block therapy by administering potassium iodide in case of radioactive iodine ingestion
Removal therapy including gastric lavage in unknown radio nuclide ingestion.
Fundamentals In Radiology