Prussian Blue for Treatment of Radiocesium Poisoning

Dennis F. Thompson, Pharm.D., FASHP, FCCP, and Chelsea O. Church, Pharm.D.

Disclosures

Pharmacotherapy. 2001;21(11) 

In This Article

Cesium Toxicology

Cesium is of particular importance because the cesium-137 isotope is a principal constituent of radioactive fallout and is a component of radiation therapy devices. The radiation half-life of cesium is approximately 30 years, making it an environmental hazard for several generations.[5,6]

Once cesium enters the body, it closely follows potassium and is uniformly distributed through-out the system, with higher concentrations found in the liver, skeletal muscles, and red blood cells. Symptoms depend on source of contact and amount of exposure. Dermal exposure can range from mild skin irritation to necrotizing lesions. Victims typically present with gastrointestinal complaints such as severe nausea, vomiting, and diarrhea. Systemic involvement eventually leads to bone marrow suppression with risk of infection, hemorrhage, and death.[1,3,4,5]

Cesium is well absorbed orally and follows first-order kinetics during elimination. Cesium is eliminated in humans primarily through the kidneys, with about 10% fecal excretion.[6,7] The physiologic half-life of cesium excretion in humans is 50-150 days.[8,9] Investigators have tried to correlate age, height, weight, and sex to individual elimination rate half-lives. Data suggest that weight appears to be the best predictor of cesium elimination half-life, with the half-life increasing with increasing body weight.[10]

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