Details About Generic Salt ::  Pamidron

Main Medicine Class:: Hormone, Bisphosphonate   

(pam-IH-DROE-nate die-SO-dee-uhm)
Aredia
Powder for injection, lyophilized: 30 mg
Powder for injection, lyophilized: 90 mg
Class: Hormone, Bisphosphonate

 

Drugs Class ::

 Action Inhibits normal and abnormal bone resorption.

Indications for Drugs ::

 Indications Treatment of moderate to severe hypercalcemia associated with malignancy with or without bone metastases; treatment of Paget disease of bone; treatment of osteolytic bone lesions of multiple myeloma in conjunction with standard antimyeloma chemotherapy.

Treatment of postmenopausal osteoporosis; control of bone metastases from breast cancer; treatment of hyperparathyroidism; prevention of glucocorticoid-induced osteoporosis; management of immobilization-related hypercalcemia.

Drug Dose ::

 Route/Dosage

Moderate to Severe Hypercalcemia of Malignancy

Adults: IV Moderate: 60 to 90 mg as an initial single-dose infusion over 2 to 24 hr. Severe: 90 mg given as an initial single-dose infusion over 2 to 24 hr. Retreatment: Same as initial therapy, on or after 7 days.

Osteolytic Bone Metastases of Breast Cancer

Adults: IV 90 mg as a 2-hr infusion q 3 to 4 wk.

Osteolytic Bone Lesions of Multiple Myeloma

Adults: IV 90 mg as a 4-hr infusion on a monthly basis.

Paget Disease

Adults: IV 30 mg/day as a 4-hr infusion on 3 consecutive days for a total dose of 90 mg. Retreatment: Same as initial therapy, when clinically indicated.

Contraindication ::

 Contraindications Hypersensitivity to bisphosphonates.

Drug Precautions ::

 Precautions

Pregnancy: Category D. Lactation: Undetermined. Children: Safety and efficacy not established. Hypocalcemia: Hypocalcemia has occurred. Renal effects: Pamidronate has not been tested in patients who have class Dc renal impairment (creatinine above 5 mg/dL); use with caution. GI disorders: Use with caution in patients with active upper GI problems such as dysphagia (eg, difficulty swallowing), symptomatic esophageal diseases, gastritis, duodenitis, or ulcers.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CARDIOVASCULAR: Hypertension; atrial fibrillation; syncope; tachycardia. CNS: Fatigue; headache; insomnia; psychosis; drowsiness. EENT: Uveitis; iritis. GI: Abdominal pain; anorexia; constipation; diarrhea; GI hemorrhage; stomatitis; dyspepsia; nausea; vomiting. GU: UTI; uremia. HEMATOLOGIC: Anemia; leukopenia; neutropenia; thrombocytopenia. METABOLIC: Hypophosphatemia; hypomagnesemia; hypothyroidism; hypokalemia; hypocalcemia. RESPIRATORY: Upper respiratory tract infection; rales/rhinitis. OTHER: Infusion site reaction (eg, redness, swelling, or induration; pain on palpation); transient mild elevation of temperature 24 to 48 hr after administration; bone pain; fluid overload; generalized pain; back pain; arthrosis; myalgias; arthralgias; moniliasis; edema.

Drug Mode of Action ::  

 Action Inhibits normal and abnormal bone resorption.

Drug Interactions ::

 Interactions None well documented.

Calcium-containing infusion solutions (eg, Ringer’s solution). Do not mix.

Drug Assesment ::

 Assessment/Interventions

  • Monitor electrolytes, creatinine, CBC, and differentials.
  • Carefully monitor patients with preexisting anemia, leukopenia, or thrombocytopenia in the first 2 wk after treatment.
  • Obtain patient history, including drug history and any known allergies.
  • Monitor hemoglobin, potassium, magnesium, and phosphate levels before and during treatment.
  • Monitor temperature before and during treatment.
  • In patients with hypercalcemia, perform periodic evaluations of renal function.
  • If infusion site reaction develops (eg, redness, swelling induration, pain, palpations), discontinue infusion, elevate site, and apply ice pack for 15 to 20 min q 4 to 6 hr for 72 hr.
  • If fluid overload develops, give diuretics as ordered.
OVERDOSAGE: SIGNS & SYMPTOMS
  High fever, hypotension, transient taste perversion

Drug Storage/Management ::

 Administration/Storage

Hypercalcemia of malignancy

  • Dilute reconstituted solution in 1000 mL saline solution or D5W. Solution is stable up to 24 hr if refrigerated.

Paget disease or osteolytic bone lesions of multiple myeloma

  • Dilute recommended dose in 500 mL of 0.45% or 0.9% saline solution or D5W.
  • Reconstitute powder in vial with 10 mL Sterile Water for Injection. Reconstituted pamidronate is stable for up to 24 hr when stored under refrigeration.
  • Hydrate patient adequately during treatment but do not overhydrate, especially patients who have cardiac failure.
  • Minimum of 7 days between treatments is recommended.

Drug Notes ::

 Patient/Family Education

  • Instruct patient to adjust diet, restrict activity, and take antiemetics if nausea and vomiting develop.
  • Explain that fever is a common side effect of this medication but is usually self-limiting. Fatigue or drowsiness also are common.
  • Instruct patient to report the following symptoms to health care provider: tingling, numbness, stomach pain, fever, irritation or pain at the injection site, fatigue, swelling, nausea, loss of appetite, constipation, diarrhea, upset stomach, vomiting, sleeplessness, inflammation of the mouth, difficulty breathing, muscle pain, drowsiness, difficult urination.

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.

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