THE EFFECTIVENESS OF ORAL AMMONIUM CHLORIDE ON INCREASED EXCRETION OF RADIOSTRONTIUM IN MAN
The effectiveness of oral ammonium chloride as an agent capable of decreasing body retention of radiostrontium was examined. Strontium-85 was used in these experiments because it is considerably less hazardous than Sr/sup 90/. Both isotopes share a similar metabolic pattern of behavior. Two patients were studied. One was a 61 year old negro (Patient A) who had had polyneuritis, malnutrition, and mild osteoporosis. He was much improved and ambulatory at the time of these studies. The other patient was a 62 year old white man (Patient B) who had Paget's disease. Both were maintained on a low calcium diet (150 mg a day). In the control study, an intravenous dose of Sr/sup 85/ was administered. Blood, urine, and stool specimens at regular intervals were studied for radioactivity in a scintillation counter. Following an interval, a second study was commenced. In this study 9 g of ammonium chloride in the form of enteric coated tablets were given 1 day prior to administration of the isotope and for 8 days thereafter. In the control study, Patient A excreted in urine 7.8 per cent of the administered dose of the isotope within 24 hr and 32.4 per cent at the end of 14 days. Plasma levels dropped sharply during the first hour following Sr/sup 85/ injection and then declined gradually. Total stool excretion at the end of 14 days was 13.5 per cent. When the patient was given ammonium chloride, his urine contained 14.7 per cent of the administered dose of the isotope in the first 24 hr and 62.3 per cent by the end of the 14th day. Disappearance rate of strontium from plasma was steeper than in the control study. Stool excretion amounted to 11.5 per cent. Hence, with ammonium chloride only 26.2 per cent of the administered dose remained in body tissues as compared to 54.1 per cent in the control study. There was also a very striking increase in calcium excretion in the urine in this latter study. Patient B excreted in urine 4 per cent of the administered dose of the isotope within 24 hr and 13.9 per cent at the end of 12 days. Plasma levels of isotope were lower than that of Patient A by 2-fold. Stool contained 7.4 per cent of the dose. When ammonium chloride was given, this patient excreted in urine 8.4 per cent of the administered dose of Sr/sup 85/ within 24 hr and 38.3 per cent at the end of 12 days. A striking enhancement in urinary calcium was also found in this patient when ammonium chloride was given. Total stool excretion amounted to 8.2 per cent. Hence, with ammonium chloride administration only 54.5 per cent of the administered dose remained in body tissues as compared to 78.7 per cent in the control study. This avidity for Sr/ sup 85/ demonstrated in this patient paralleled a similar avidity for calcium. This had been demonstrated prior to these studies by low urinary calcium excretion levels and by retention of a large percentage of a given intravenous test dose of calcium gluconate. When it was discovered that the enteric coated ammonium chloride tablets were responsible for a very large stool excretion of calcium, a third study was carried out using ammonium chloride tablets containing only very small amounts of calcium. Again a very striking enhancement of Sr/sup 85/ and calcium excretion was observed to occur. It is believed that the effectiveness of ammonium chloride in reducing body retention of Sr/sup 85/ results from the metabolic acidosis which mobilizes skeletal calcium and increases renal excretion of calcium and Sr/sup 85/. In this manner skeletal deposition of the radio-strontium is decreased. Emphasis is given to the fact that enhancement of Sr/sup 85/ excretion was favored by the early administration of ammonium chloride following a dose of Sr/sup 85/. That is, when the plasma and soft tissue concentration of this radioactive element were highest and when it was not yet firmly lodged in the skeleton. (auth)
- Research Organization:
- Montefiore Hospital, New York
- NSA Number:
- NSA-13-021873
- OSTI ID:
- 4230712
- Journal Information:
- Intern. J. Appl. Radiation and Isotopes, Journal Name: Intern. J. Appl. Radiation and Isotopes Vol. Vol: 5
- Country of Publication:
- Country unknown/Code not available
- Language:
- English
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