Week/day | Treatment | Observation |
0/0 | DMSA 3 times per day for 5 days* | 1, 2, 3, 4, 5 |
Vitamins and milk¶ | ||
0/5 | DMSA twice a day for 14 days* | 2, 3, 4 |
Calcium and iron supplementation if necessary | ||
1/7 | 2, 3, 4 | |
3/21 | 1, 2, 3, 4 | |
5/35 | 3 and other tests to check previous abnormalities or as clinically necessary | |
7/49 | 1, 3 | |
9/63 | 3 | |
11/77 | 1, 3 | |
Lead levels are then obtained at 15 weeks and then every 1-2 months until <45 mcg/dL (2.17 micromol/L) with history and physical examination every other visit. The frequency of visits is individualized by patent's needs. | ||
Retreat if level rebounds to >80 percent of original blood level and is ≥45 mcg/dL (2.17 micromol/L). | ||
1. History and physical exam | ||
2. Complete blood count, urinalysis | ||
3. Venous lead level and free erythrocyte protoporphyrin | ||
4. Serum electrolytes, glucose, blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, calcium, magnesium | ||
5. Iron panel (serum iron, total iron binding capacity [transferrin], and ferritin) |
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