Chelating agents have long been used in the pharmacological treatment of
lead poisoning, whose management is still a problem, particularly in developing countries. This article reviews the pharmacological properties of dimercaprole, peniclliamine. CaNa2EDTA and dimercaprosuccinic
acid, examines their indications,
contraindications and side effects and discusses the possible use of each
drug in occupational Pb
poisoning. Proposals are also presented for the treatment and follow-up of subjects with signs and symptoms of
poisoning and of subjects with low-moderate Pb absorption. CaNa2EDTA seems to be the most reliable and safer
chelating agent nowadays available and with a wider spectrum of action.
DMSA seems to be promising in the treatment of occupational Pb
poisoning. Even though there is no doubt that
chelation therapy has significantly contributed to reduce mortality and morbidity from occupational Pb
poisoning, the efficacy of this treatment in subjects with subtle neurological or renal damage has not yet been studied properly.