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Introduction
I.V. Carrier Solutions
Infusion Admixture Ranges
Miscellaneous Admixtures
Emergency Injections
Example Protocol Based on ACAM Protocol
Footnotes
 

Introduction

This brief compendium of medications is not intended to replace or supercede the American College of Advancement in Medicine (ACAM) or Great Lakes College of Clinical Medicine (GLCCM) Protocol for EDTA Chelation Therapy. This compendium is our attempt to aid the physician who is already familiar with this protocol but who needs a ready reference to rapidly correlate a patient's unique needs to the ACAM/GLCCM Protocol.

The medications used in EDTA Chelation Therapy may vary by type and dose depending upon the individual needs of the patient. This compendium is designed to be a useful summation of the "Treatment Procedures" section of the ACAM/GLCCM Protocol.

Some of the information contained herein was obtained from the ACAM Workshops on EDTA Chelation Therapy. While this information is not covered by the protocol its inclusion here was deemed beneficial as background material. All information derived from the ACAM Workshop is clearly labeled as such.

I.V. Carrier Solutions

The chelating physician may use one of several I.V. Solutions. Each I.V. solution has it’s own unique benefits and risks.

Sterile Water for Injection is beneficial as a carrier solution because of it’s zero osmolarity. Further, Sterile Water for Injection does not contain Sodium, Dextrose or Lactate molecules so once isotonicity is achieved the sterile water will have minimal effect on the patient. The combination of Sterile Water for Injection with several admixtures (especially Ascorbic Acid) generally results in an I.V. solution which approximates isotonic conditions. The risk of Sterile Water for Injection is that without admixtures, it is hypotonic and hemolytic. No injection of sterile water is to be given until it is made approximately isotonic by the addition of appropriate solute.

0.45% Sodium Chloride Injection is beneficial as a carrier solution because of it’s low osmotic pressure. The combination of 0.45% Sodium Chloride Injection with several admixtures generally results in a hypertonic solution. The risk of 0.45% Sodium Chloride Injection is the added Sodium content in the final solution.²

5% Dextrose in Water for Injection is beneficial as a carrier solution because of the calories it provides during the treatment. Additionally, unlike Sodium Chloride or Lactated Ringer’s Injections it does not contain Sodium. The combination of 5% Dextrose in Water with just a few admixtures generally results in a hypertonic solution. The risk of 5% Dextrose in Water is for the diabetic patient which may not tolerate the added dextrose well. It is generally believed however, that a 5% Dextrose solution given over four hours does not maintain a significant risk to diabetic patients.³

0.9% Sodium Chloride Injection is beneficial as a carrier solution because it is isotonic and closely aligned with intra-cellular fluids. The combination of 0.9% Sodium Chloride with just a few admixtures results in a significant hypertonic solution. The risk of 0.9% Sodium Chloride is the added Sodium content in the final solution.⁴

Lactated Ringers Injection is beneficial because of its own mild chelating properties. The risk of Lactated Ringer’s Injection is that it is slightly hypertonic and when combined with admixtures will generally become significantly hypertonic. Additionally, Lactated Ringer's Injection contains three millimoles of Calcium which consumes 34% of the EDTA activity. Lactated Ringer’s Injection adds to the Sodium content of the final solution.⁵

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Infusion Admixture Ranges

The following admixtures are added to the I.V. carrier solution prior to administration. Admixtures shown in BLUE are currently available from Compounding Pharmacies

Miscellaneous Admixtures

The following injections are approved for admixture status for EDTA Chelation Therapy but are less important. Their use varies with physician preference.

Emergency Injections for EDTA Chelation Therapy

The following injectables should be on hand (in addition to a crash cart) for emergency use if needed.

 

Footnotes:

1. A careful review of this protocol should be made before attempting this therapy. Please write or call the American College of Advancement in Medicine (23121 Verdugo Drive, Suite 204 Laguna Hills, California 92653 (714) 583-7666 (800) 532-3688) for a complete protocol.

2. ACAM Chelation Therapy Workshop. Each 100mL of 0.45% Sodium Chloride for Injection contains 0.45grams of Sodium Chloride.

3. ACAM Chelation Therapy Workshop. There are 85 calories in a 500mL solution of 5% Dextrose in Water for Injection. This equates to 28.3 calories per hour, over a three hour period. The maximum rate at which dextrose can be infused without producing glycosuria is 0.5g/kg/hr. About 95% is retained when infused at 0.8g/kg/hr.

4. ACAM Chelation Therapy Workshop. Each 100mL of 0.9% Sodium Chloride for Injection contains 0.90 grams of Sodium Chloride.

5. ACAM Chelation Therapy Workshop. Each 100mL of Lactated Ringer's Injection contains 0.60grams of Sodium Chloride.

6. If creatinine clearance is less than 100mL/min, the dose based on body weight is reduced. Please see ACAM /GLCCM Protocol.

7. Recommended in ACAM protocol as "better tolerated" than other types of Ascorbic Acid. Additionally, Ascorbic Acid w/EDTA has a lower osmotic pressure than Ascorbic Acid w/Monothioglycerol.