Choice of chelating antidotes for acute cadmium intoxication∗

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Abstract
During acute oral intoxication by cadmium compounds, gastrointestinal epithelial damage contributes to immediate toxicity. However, secondary systemic toxicity may develop due to intestinal uptake of cadmium. This review presents an evaluation of the effects of chelators on the acute toxicity of cadmium after parenteral or oral exposure and on the intestinal uptake of cadmium. This review shows: In conclusion, chelation treatment in acute oral cadmium intoxication should first prevent/reduce intestinal damage and uptake by rapid oral administration of a chelating antidote and then alleviate systemic toxicity due to absorbed cadmium and enhance renal/biliary cadmium excretion by parenteral administration of a chelating antidote.