Contraindications

Parenteral form: Once diagnosis of PCP is made, there are no absolute contraindications. Inhalation: History of anaphylactic reaction to pentamidine.

 

Route/Dosage

ADULTS & CHILDREN: IM/IV 4 mg/kg qd for 14 days. ADULTS: Inhalation 300 mg once q 4 wk administered via Respirgard II nebulizer.

 

Interactions INCOMPATIBILITIES: Do not reconstitute with saline solutions. Do not mix with other drugs.

 

Lab Test Interferences None well documented.

 

Adverse Reactions

CV: Hypotension; ventricular tachycardia; cardiac arrhythmias; chest pain; edema; phlebitis. CNS: Confusion; hallucinations; dizziness; fatigue; headache. DERM: Stevens-Johnson syndrome; sterile abscess, pain or induration at IM injection site; rash. EENT: Bad or metallic taste. GI: Nausea; anorexia; vomiting; diarrhea; abdominal pain. GU: Acute renal failure; elevated serum creatinine. HEMA: Leukopenia; thrombocytopenia; anemia; pancytopenia. HEPA: Elevated liver function test results. META: Hypoglycemia; hypocalcemia; hyperkalemia. RESP: Shortness of breath; cough; pharyngitis; chest congestion; bronchospasm; pneumothorax (generally associated with inhalation). OTHER: Neuralgia; myalgia; night sweats, chills.

 

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy of inhalation solution not established. Special-risk patients: Use drug with caution in patients with hypertension, hypotension, hypoglycemia, hyperglycemia, hypocalcemia, leukopenia, thrombocytopenia, anemia, hepatic or renal dysfunction, ventricular tachycardia, pancreatitis, Stevens-Johnson syndrome. Development of acute PCP: Acute PCP may develop despite pentamidine prophylaxis. Fatalities: Fatalities from severe hypotension (even after one dose), hypoglycemia and cardiac arrhythmias have been reported with IM and IV routes. Renal failure: Reduction of dosage, longer infusion time, or extension of dosing interval may be required.

PATIENT CARE CONSIDERATIONS

 

Administration/Storage

• For parenteral use, dissolve contents of vial in Sterile Water for Injection or D5W as directed.
• For IV infusion, solution may be diluted further in D5W.
• Infuse pentamidine IV over 1 hr with patient supine to minimize severe hypotension and arrhythmias.
• Monitor BP continuously throughout infusion, every 30 min for 2 hr thereafter and then every 4 hr until BP stabilizes.
• For IM administration, inject deeply and rotate sites.
• Reconstitute medication for inhalation in Sterile Water for Injection, USP. Do not mix with any other drugs.
• Deliver aerosol dose until nebulizer chamber is empty (»30 to 45 min).
• Reconstituted aerosol preparation is stable up to 48 hr at room temperature, if protected from light source. Discard unused portion.
• IV solutions prepared with D5W are stable at room temperature for up to 48 hr. Discard unused portion.
• Store unopened vial at room temperature. Protect from light.

 

Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Assess for adverse reactions throughout course of therapy (eg, hypotension, chest pain, neuralgia, phlebitis, edema, headache, nausea, night sweats, chills).
• If patient is coughing, provide physical support to patient’s chest. Institute measures to reduce nonproductive coughing to decrease expenditure and chest pain.
• Protect immunocompromised patient from additional infections and stress.
• Consult with nutritionist to maintain optimal diet for patient.
• Inspect injection sites periodically for signs of induration or sterile abscess.
• Obtain prescription for antiemetic agent if needed.
• Keep emergency resuscitation equipment available.
• Monitor lab studies for leukopenia, thrombocytopenia, elevated serum creatinine, elevated liver function studies, hypoglycemia, hypocalcemia, or hyperkalemia.
• Monitor vital signs ³ q 4 hr during therapy.
• Monitor BP before, during, and after pentamidine administration.
• Monitor I&O throughout therapy. If urinary output is decreased, notify physician immediately.
• If patient experiences anorexia, nausea, and vomiting, increased hydration will be necessary.
• If vertigo, emotional changes, or seizures occur, take safety precautions.
• Notify physician if GI reactions persist or worsen.

 

Patient/Family Education

• Inform the patient that there may be pain at the injection site with IM administration.
• Caution patient to avoid crowds and persons with known infections.
• Instruct patient to report the following symptoms to physician: Nausea, vomiting, anorexia, diarrhea, oliguria, dizziness, chest pain, or edema.
• Advise patient that drug may cause dizziness, and to use caution while driving or performing other tasks requiring mental alertness.

Indications for Drugs ::

(pen-TAM-ih-deen ice-uh-THIGH-uh-nate)

NebuPent, Pentacarinat, Pentam 300,  Pentacarinet

Class: Anti-infective/Antiprotozoal

 

Action Mechanism of action not fully understood. Interferes with synthesis of DNA, RNA, phospholipids and proteins.

 

Indications

Parenteral form: Treatment of Pneumocystis carinii pneumonia (PCP). Inhalation: Prevention of PCP in highrisk HIV-infected patients. Unlabeled use(s): Treatment of trypanosomiasis and visceral leishmaniasis.

 

Contraindications

Parenteral form: Once diagnosis of PCP is made, there are no absolute contraindications. Inhalation: History of anaphylactic reaction to pentamidine.

 

Route/Dosage

ADULTS & CHILDREN: IM/IV 4 mg/kg qd for 14 days. ADULTS: Inhalation 300 mg once q 4 wk administered via Respirgard II nebulizer.

 

Interactions INCOMPATIBILITIES: Do not reconstitute with saline solutions. Do not mix with other drugs.

 

Lab Test Interferences None well documented.

 

Adverse Reactions

CV: Hypotension; ventricular tachycardia; cardiac arrhythmias; chest pain; edema; phlebitis. CNS: Confusion; hallucinations; dizziness; fatigue; headache. DERM: Stevens-Johnson syndrome; sterile abscess, pain or induration at IM injection site; rash. EENT: Bad or metallic taste. GI: Nausea; anorexia; vomiting; diarrhea; abdominal pain. GU: Acute renal failure; elevated serum creatinine. HEMA: Leukopenia; thrombocytopenia; anemia; pancytopenia. HEPA: Elevated liver function test results. META: Hypoglycemia; hypocalcemia; hyperkalemia. RESP: Shortness of breath; cough; pharyngitis; chest congestion; bronchospasm; pneumothorax (generally associated with inhalation). OTHER: Neuralgia; myalgia; night sweats, chills.

 

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy of inhalation solution not established. Special-risk patients: Use drug with caution in patients with hypertension, hypotension, hypoglycemia, hyperglycemia, hypocalcemia, leukopenia, thrombocytopenia, anemia, hepatic or renal dysfunction, ventricular tachycardia, pancreatitis, Stevens-Johnson syndrome. Development of acute PCP: Acute PCP may develop despite pentamidine prophylaxis. Fatalities: Fatalities from severe hypotension (even after one dose), hypoglycemia and cardiac arrhythmias have been reported with IM and IV routes. Renal failure: Reduction of dosage, longer infusion time, or extension of dosing interval may be required.

PATIENT CARE CONSIDERATIONS

 

Administration/Storage

• For parenteral use, dissolve contents of vial in Sterile Water for Injection or D5W as directed.
• For IV infusion, solution may be diluted further in D5W.
• Infuse pentamidine IV over 1 hr with patient supine to minimize severe hypotension and arrhythmias.
• Monitor BP continuously throughout infusion, every 30 min for 2 hr thereafter and then every 4 hr until BP stabilizes.
• For IM administration, inject deeply and rotate sites.
• Reconstitute medication for inhalation in Sterile Water for Injection, USP. Do not mix with any other drugs.
• Deliver aerosol dose until nebulizer chamber is empty (»30 to 45 min).
• Reconstituted aerosol preparation is stable up to 48 hr at room temperature, if protected from light source. Discard unused portion.
• IV solutions prepared with D5W are stable at room temperature for up to 48 hr. Discard unused portion.
• Store unopened vial at room temperature. Protect from light.

 

Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Assess for adverse reactions throughout course of therapy (eg, hypotension, chest pain, neuralgia, phlebitis, edema, headache, nausea, night sweats, chills).
• If patient is coughing, provide physical support to patient’s chest. Institute measures to reduce nonproductive coughing to decrease expenditure and chest pain.
• Protect immunocompromised patient from additional infections and stress.
• Consult with nutritionist to maintain optimal diet for patient.
• Inspect injection sites periodically for signs of induration or sterile abscess.
• Obtain prescription for antiemetic agent if needed.
• Keep emergency resuscitation equipment available.
• Monitor lab studies for leukopenia, thrombocytopenia, elevated serum creatinine, elevated liver function studies, hypoglycemia, hypocalcemia, or hyperkalemia.
• Monitor vital signs ³ q 4 hr during therapy.
• Monitor BP before, during, and after pentamidine administration.
• Monitor I&O throughout therapy. If urinary output is decreased, notify physician immediately.
• If patient experiences anorexia, nausea, and vomiting, increased hydration will be necessary.
• If vertigo, emotional changes, or seizures occur, take safety precautions.
• Notify physician if GI reactions persist or worsen.

 

Patient/Family Education

• Inform the patient that there may be pain at the injection site with IM administration.
• Caution patient to avoid crowds and persons with known infections.
• Instruct patient to report the following symptoms to physician: Nausea, vomiting, anorexia, diarrhea, oliguria, dizziness, chest pain, or edema.
• Advise patient that drug may cause dizziness, and to use caution while driving or performing other tasks requiring mental alertness.

Drug Dose ::

(pen-TAM-ih-deen ice-uh-THIGH-uh-nate)

NebuPent, Pentacarinat, Pentam 300,  Pentacarinet

Class: Anti-infective/Antiprotozoal

 

Action Mechanism of action not fully understood. Interferes with synthesis of DNA, RNA, phospholipids and proteins.

 

Indications

Parenteral form: Treatment of Pneumocystis carinii pneumonia (PCP). Inhalation: Prevention of PCP in highrisk HIV-infected patients. Unlabeled use(s): Treatment of trypanosomiasis and visceral leishmaniasis.

 

Contraindications

Parenteral form: Once diagnosis of PCP is made, there are no absolute contraindications. Inhalation: History of anaphylactic reaction to pentamidine.

 

Route/Dosage

ADULTS & CHILDREN: IM/IV 4 mg/kg qd for 14 days. ADULTS: Inhalation 300 mg once q 4 wk administered via Respirgard II nebulizer.

 

Interactions INCOMPATIBILITIES: Do not reconstitute with saline solutions. Do not mix with other drugs.

 

Lab Test Interferences None well documented.

 

Adverse Reactions

CV: Hypotension; ventricular tachycardia; cardiac arrhythmias; chest pain; edema; phlebitis. CNS: Confusion; hallucinations; dizziness; fatigue; headache. DERM: Stevens-Johnson syndrome; sterile abscess, pain or induration at IM injection site; rash. EENT: Bad or metallic taste. GI: Nausea; anorexia; vomiting; diarrhea; abdominal pain. GU: Acute renal failure; elevated serum creatinine. HEMA: Leukopenia; thrombocytopenia; anemia; pancytopenia. HEPA: Elevated liver function test results. META: Hypoglycemia; hypocalcemia; hyperkalemia. RESP: Shortness of breath; cough; pharyngitis; chest congestion; bronchospasm; pneumothorax (generally associated with inhalation). OTHER: Neuralgia; myalgia; night sweats, chills.

 

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy of inhalation solution not established. Special-risk patients: Use drug with caution in patients with hypertension, hypotension, hypoglycemia, hyperglycemia, hypocalcemia, leukopenia, thrombocytopenia, anemia, hepatic or renal dysfunction, ventricular tachycardia, pancreatitis, Stevens-Johnson syndrome. Development of acute PCP: Acute PCP may develop despite pentamidine prophylaxis. Fatalities: Fatalities from severe hypotension (even after one dose), hypoglycemia and cardiac arrhythmias have been reported with IM and IV routes. Renal failure: Reduction of dosage, longer infusion time, or extension of dosing interval may be required.

PATIENT CARE CONSIDERATIONS

 

Administration/Storage

• For parenteral use, dissolve contents of vial in Sterile Water for Injection or D5W as directed.
• For IV infusion, solution may be diluted further in D5W.
• Infuse pentamidine IV over 1 hr with patient supine to minimize severe hypotension and arrhythmias.
• Monitor BP continuously throughout infusion, every 30 min for 2 hr thereafter and then every 4 hr until BP stabilizes.
• For IM administration, inject deeply and rotate sites.
• Reconstitute medication for inhalation in Sterile Water for Injection, USP. Do not mix with any other drugs.
• Deliver aerosol dose until nebulizer chamber is empty (»30 to 45 min).
• Reconstituted aerosol preparation is stable up to 48 hr at room temperature, if protected from light source. Discard unused portion.
• IV solutions prepared with D5W are stable at room temperature for up to 48 hr. Discard unused portion.
• Store unopened vial at room temperature. Protect from light.

 

Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Assess for adverse reactions throughout course of therapy (eg, hypotension, chest pain, neuralgia, phlebitis, edema, headache, nausea, night sweats, chills).
• If patient is coughing, provide physical support to patient’s chest. Institute measures to reduce nonproductive coughing to decrease expenditure and chest pain.
• Protect immunocompromised patient from additional infections and stress.
• Consult with nutritionist to maintain optimal diet for patient.
• Inspect injection sites periodically for signs of induration or sterile abscess.
• Obtain prescription for antiemetic agent if needed.
• Keep emergency resuscitation equipment available.
• Monitor lab studies for leukopenia, thrombocytopenia, elevated serum creatinine, elevated liver function studies, hypoglycemia, hypocalcemia, or hyperkalemia.
• Monitor vital signs ³ q 4 hr during therapy.
• Monitor BP before, during, and after pentamidine administration.
• Monitor I&O throughout therapy. If urinary output is decreased, notify physician immediately.
• If patient experiences anorexia, nausea, and vomiting, increased hydration will be necessary.
• If vertigo, emotional changes, or seizures occur, take safety precautions.
• Notify physician if GI reactions persist or worsen.

 

Patient/Family Education

• Inform the patient that there may be pain at the injection site with IM administration.
• Caution patient to avoid crowds and persons with known infections.
• Instruct patient to report the following symptoms to physician: Nausea, vomiting, anorexia, diarrhea, oliguria, dizziness, chest pain, or edema.
• Advise patient that drug may cause dizziness, and to use caution while driving or performing other tasks requiring mental alertness.

Contraindication ::

(pen-TAM-ih-deen ice-uh-THIGH-uh-nate)

NebuPent, Pentacarinat, Pentam 300,  Pentacarinet

Class: Anti-infective/Antiprotozoal

 

Action Mechanism of action not fully understood. Interferes with synthesis of DNA, RNA, phospholipids and proteins.

 

Indications

Parenteral form: Treatment of Pneumocystis carinii pneumonia (PCP). Inhalation: Prevention of PCP in highrisk HIV-infected patients. Unlabeled use(s): Treatment of trypanosomiasis and visceral leishmaniasis.

 

Contraindications

Parenteral form: Once diagnosis of PCP is made, there are no absolute contraindications. Inhalation: History of anaphylactic reaction to pentamidine.

 

Route/Dosage

ADULTS & CHILDREN: IM/IV 4 mg/kg qd for 14 days. ADULTS: Inhalation 300 mg once q 4 wk administered via Respirgard II nebulizer.

 

Interactions INCOMPATIBILITIES: Do not reconstitute with saline solutions. Do not mix with other drugs.

 

Lab Test Interferences None well documented.

 

Adverse Reactions

CV: Hypotension; ventricular tachycardia; cardiac arrhythmias; chest pain; edema; phlebitis. CNS: Confusion; hallucinations; dizziness; fatigue; headache. DERM: Stevens-Johnson syndrome; sterile abscess, pain or induration at IM injection site; rash. EENT: Bad or metallic taste. GI: Nausea; anorexia; vomiting; diarrhea; abdominal pain. GU: Acute renal failure; elevated serum creatinine. HEMA: Leukopenia; thrombocytopenia; anemia; pancytopenia. HEPA: Elevated liver function test results. META: Hypoglycemia; hypocalcemia; hyperkalemia. RESP: Shortness of breath; cough; pharyngitis; chest congestion; bronchospasm; pneumothorax (generally associated with inhalation). OTHER: Neuralgia; myalgia; night sweats, chills.

 

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy of inhalation solution not established. Special-risk patients: Use drug with caution in patients with hypertension, hypotension, hypoglycemia, hyperglycemia, hypocalcemia, leukopenia, thrombocytopenia, anemia, hepatic or renal dysfunction, ventricular tachycardia, pancreatitis, Stevens-Johnson syndrome. Development of acute PCP: Acute PCP may develop despite pentamidine prophylaxis. Fatalities: Fatalities from severe hypotension (even after one dose), hypoglycemia and cardiac arrhythmias have been reported with IM and IV routes. Renal failure: Reduction of dosage, longer infusion time, or extension of dosing interval may be required.

PATIENT CARE CONSIDERATIONS

 

Administration/Storage

• For parenteral use, dissolve contents of vial in Sterile Water for Injection or D5W as directed.
• For IV infusion, solution may be diluted further in D5W.
• Infuse pentamidine IV over 1 hr with patient supine to minimize severe hypotension and arrhythmias.
• Monitor BP continuously throughout infusion, every 30 min for 2 hr thereafter and then every 4 hr until BP stabilizes.
• For IM administration, inject deeply and rotate sites.
• Reconstitute medication for inhalation in Sterile Water for Injection, USP. Do not mix with any other drugs.
• Deliver aerosol dose until nebulizer chamber is empty (»30 to 45 min).
• Reconstituted aerosol preparation is stable up to 48 hr at room temperature, if protected from light source. Discard unused portion.
• IV solutions prepared with D5W are stable at room temperature for up to 48 hr. Discard unused portion.
• Store unopened vial at room temperature. Protect from light.

 

Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Assess for adverse reactions throughout course of therapy (eg, hypotension, chest pain, neuralgia, phlebitis, edema, headache, nausea, night sweats, chills).
• If patient is coughing, provide physical support to patient’s chest. Institute measures to reduce nonproductive coughing to decrease expenditure and chest pain.
• Protect immunocompromised patient from additional infections and stress.
• Consult with nutritionist to maintain optimal diet for patient.
• Inspect injection sites periodically for signs of induration or sterile abscess.
• Obtain prescription for antiemetic agent if needed.
• Keep emergency resuscitation equipment available.
• Monitor lab studies for leukopenia, thrombocytopenia, elevated serum creatinine, elevated liver function studies, hypoglycemia, hypocalcemia, or hyperkalemia.
• Monitor vital signs ³ q 4 hr during therapy.
• Monitor BP before, during, and after pentamidine administration.
• Monitor I&O throughout therapy. If urinary output is decreased, notify physician immediately.
• If patient experiences anorexia, nausea, and vomiting, increased hydration will be necessary.
• If vertigo, emotional changes, or seizures occur, take safety precautions.
• Notify physician if GI reactions persist or worsen.

 

Patient/Family Education

• Inform the patient that there may be pain at the injection site with IM administration.
• Caution patient to avoid crowds and persons with known infections.
• Instruct patient to report the following symptoms to physician: Nausea, vomiting, anorexia, diarrhea, oliguria, dizziness, chest pain, or edema.
• Advise patient that drug may cause dizziness, and to use caution while driving or performing other tasks requiring mental alertness.

Drug Precautions ::

(pen-TAM-ih-deen ice-uh-THIGH-uh-nate)

NebuPent, Pentacarinat, Pentam 300,  Pentacarinet

Class: Anti-infective/Antiprotozoal

 

Action Mechanism of action not fully understood. Interferes with synthesis of DNA, RNA, phospholipids and proteins.

 

Indications

Parenteral form: Treatment of Pneumocystis carinii pneumonia (PCP). Inhalation: Prevention of PCP in highrisk HIV-infected patients. Unlabeled use(s): Treatment of trypanosomiasis and visceral leishmaniasis.

 

Contraindications

Parenteral form: Once diagnosis of PCP is made, there are no absolute contraindications. Inhalation: History of anaphylactic reaction to pentamidine.

 

Route/Dosage

ADULTS & CHILDREN: IM/IV 4 mg/kg qd for 14 days. ADULTS: Inhalation 300 mg once q 4 wk administered via Respirgard II nebulizer.

 

Interactions INCOMPATIBILITIES: Do not reconstitute with saline solutions. Do not mix with other drugs.

 

Lab Test Interferences None well documented.

 

Adverse Reactions

CV: Hypotension; ventricular tachycardia; cardiac arrhythmias; chest pain; edema; phlebitis. CNS: Confusion; hallucinations; dizziness; fatigue; headache. DERM: Stevens-Johnson syndrome; sterile abscess, pain or induration at IM injection site; rash. EENT: Bad or metallic taste. GI: Nausea; anorexia; vomiting; diarrhea; abdominal pain. GU: Acute renal failure; elevated serum creatinine. HEMA: Leukopenia; thrombocytopenia; anemia; pancytopenia. HEPA: Elevated liver function test results. META: Hypoglycemia; hypocalcemia; hyperkalemia. RESP: Shortness of breath; cough; pharyngitis; chest congestion; bronchospasm; pneumothorax (generally associated with inhalation). OTHER: Neuralgia; myalgia; night sweats, chills.

 

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy of inhalation solution not established. Special-risk patients: Use drug with caution in patients with hypertension, hypotension, hypoglycemia, hyperglycemia, hypocalcemia, leukopenia, thrombocytopenia, anemia, hepatic or renal dysfunction, ventricular tachycardia, pancreatitis, Stevens-Johnson syndrome. Development of acute PCP: Acute PCP may develop despite pentamidine prophylaxis. Fatalities: Fatalities from severe hypotension (even after one dose), hypoglycemia and cardiac arrhythmias have been reported with IM and IV routes. Renal failure: Reduction of dosage, longer infusion time, or extension of dosing interval may be required.

PATIENT CARE CONSIDERATIONS

 

Administration/Storage

• For parenteral use, dissolve contents of vial in Sterile Water for Injection or D5W as directed.
• For IV infusion, solution may be diluted further in D5W.
• Infuse pentamidine IV over 1 hr with patient supine to minimize severe hypotension and arrhythmias.
• Monitor BP continuously throughout infusion, every 30 min for 2 hr thereafter and then every 4 hr until BP stabilizes.
• For IM administration, inject deeply and rotate sites.
• Reconstitute medication for inhalation in Sterile Water for Injection, USP. Do not mix with any other drugs.
• Deliver aerosol dose until nebulizer chamber is empty (»30 to 45 min).
• Reconstituted aerosol preparation is stable up to 48 hr at room temperature, if protected from light source. Discard unused portion.
• IV solutions prepared with D5W are stable at room temperature for up to 48 hr. Discard unused portion.
• Store unopened vial at room temperature. Protect from light.

 

Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Assess for adverse reactions throughout course of therapy (eg, hypotension, chest pain, neuralgia, phlebitis, edema, headache, nausea, night sweats, chills).
• If patient is coughing, provide physical support to patient’s chest. Institute measures to reduce nonproductive coughing to decrease expenditure and chest pain.
• Protect immunocompromised patient from additional infections and stress.
• Consult with nutritionist to maintain optimal diet for patient.
• Inspect injection sites periodically for signs of induration or sterile abscess.
• Obtain prescription for antiemetic agent if needed.
• Keep emergency resuscitation equipment available.
• Monitor lab studies for leukopenia, thrombocytopenia, elevated serum creatinine, elevated liver function studies, hypoglycemia, hypocalcemia, or hyperkalemia.
• Monitor vital signs ³ q 4 hr during therapy.
• Monitor BP before, during, and after pentamidine administration.
• Monitor I&O throughout therapy. If urinary output is decreased, notify physician immediately.
• If patient experiences anorexia, nausea, and vomiting, increased hydration will be necessary.
• If vertigo, emotional changes, or seizures occur, take safety precautions.
• Notify physician if GI reactions persist or worsen.

 

Patient/Family Education

• Inform the patient that there may be pain at the injection site with IM administration.
• Caution patient to avoid crowds and persons with known infections.
• Instruct patient to report the following symptoms to physician: Nausea, vomiting, anorexia, diarrhea, oliguria, dizziness, chest pain, or edema.
• Advise patient that drug may cause dizziness, and to use caution while driving or performing other tasks requiring mental alertness.

Drug Side Effects ::

(pen-TAM-ih-deen ice-uh-THIGH-uh-nate)

NebuPent, Pentacarinat, Pentam 300,  Pentacarinet

Class: Anti-infective/Antiprotozoal

 

Action Mechanism of action not fully understood. Interferes with synthesis of DNA, RNA, phospholipids and proteins.

 

Indications

Parenteral form: Treatment of Pneumocystis carinii pneumonia (PCP). Inhalation: Prevention of PCP in highrisk HIV-infected patients. Unlabeled use(s): Treatment of trypanosomiasis and visceral leishmaniasis.

 

Contraindications

Parenteral form: Once diagnosis of PCP is made, there are no absolute contraindications. Inhalation: History of anaphylactic reaction to pentamidine.

 

Route/Dosage

ADULTS & CHILDREN: IM/IV 4 mg/kg qd for 14 days. ADULTS: Inhalation 300 mg once q 4 wk administered via Respirgard II nebulizer.

 

Interactions INCOMPATIBILITIES: Do not reconstitute with saline solutions. Do not mix with other drugs.

 

Lab Test Interferences None well documented.

 

Adverse Reactions

CV: Hypotension; ventricular tachycardia; cardiac arrhythmias; chest pain; edema; phlebitis. CNS: Confusion; hallucinations; dizziness; fatigue; headache. DERM: Stevens-Johnson syndrome; sterile abscess, pain or induration at IM injection site; rash. EENT: Bad or metallic taste. GI: Nausea; anorexia; vomiting; diarrhea; abdominal pain. GU: Acute renal failure; elevated serum creatinine. HEMA: Leukopenia; thrombocytopenia; anemia; pancytopenia. HEPA: Elevated liver function test results. META: Hypoglycemia; hypocalcemia; hyperkalemia. RESP: Shortness of breath; cough; pharyngitis; chest congestion; bronchospasm; pneumothorax (generally associated with inhalation). OTHER: Neuralgia; myalgia; night sweats, chills.

 

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy of inhalation solution not established. Special-risk patients: Use drug with caution in patients with hypertension, hypotension, hypoglycemia, hyperglycemia, hypocalcemia, leukopenia, thrombocytopenia, anemia, hepatic or renal dysfunction, ventricular tachycardia, pancreatitis, Stevens-Johnson syndrome. Development of acute PCP: Acute PCP may develop despite pentamidine prophylaxis. Fatalities: Fatalities from severe hypotension (even after one dose), hypoglycemia and cardiac arrhythmias have been reported with IM and IV routes. Renal failure: Reduction of dosage, longer infusion time, or extension of dosing interval may be required.

PATIENT CARE CONSIDERATIONS

 

Administration/Storage

• For parenteral use, dissolve contents of vial in Sterile Water for Injection or D5W as directed.
• For IV infusion, solution may be diluted further in D5W.
• Infuse pentamidine IV over 1 hr with patient supine to minimize severe hypotension and arrhythmias.
• Monitor BP continuously throughout infusion, every 30 min for 2 hr thereafter and then every 4 hr until BP stabilizes.
• For IM administration, inject deeply and rotate sites.
• Reconstitute medication for inhalation in Sterile Water for Injection, USP. Do not mix with any other drugs.
• Deliver aerosol dose until nebulizer chamber is empty (»30 to 45 min).
• Reconstituted aerosol preparation is stable up to 48 hr at room temperature, if protected from light source. Discard unused portion.
• IV solutions prepared with D5W are stable at room temperature for up to 48 hr. Discard unused portion.
• Store unopened vial at room temperature. Protect from light.

 

Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Assess for adverse reactions throughout course of therapy (eg, hypotension, chest pain, neuralgia, phlebitis, edema, headache, nausea, night sweats, chills).
• If patient is coughing, provide physical support to patient’s chest. Institute measures to reduce nonproductive coughing to decrease expenditure and chest pain.
• Protect immunocompromised patient from additional infections and stress.
• Consult with nutritionist to maintain optimal diet for patient.
• Inspect injection sites periodically for signs of induration or sterile abscess.
• Obtain prescription for antiemetic agent if needed.
• Keep emergency resuscitation equipment available.
• Monitor lab studies for leukopenia, thrombocytopenia, elevated serum creatinine, elevated liver function studies, hypoglycemia, hypocalcemia, or hyperkalemia.
• Monitor vital signs ³ q 4 hr during therapy.
• Monitor BP before, during, and after pentamidine administration.
• Monitor I&O throughout therapy. If urinary output is decreased, notify physician immediately.
• If patient experiences anorexia, nausea, and vomiting, increased hydration will be necessary.
• If vertigo, emotional changes, or seizures occur, take safety precautions.
• Notify physician if GI reactions persist or worsen.

 

Patient/Family Education

• Inform the patient that there may be pain at the injection site with IM administration.
• Caution patient to avoid crowds and persons with known infections.
• Instruct patient to report the following symptoms to physician: Nausea, vomiting, anorexia, diarrhea, oliguria, dizziness, chest pain, or edema.
• Advise patient that drug may cause dizziness, and to use caution while driving or performing other tasks requiring mental alertness.

Drug Mode of Action ::  

(pen-TAM-ih-deen ice-uh-THIGH-uh-nate)

NebuPent, Pentacarinat, Pentam 300,  Pentacarinet

Class: Anti-infective/Antiprotozoal

 

Action Mechanism of action not fully understood. Interferes with synthesis of DNA, RNA, phospholipids and proteins.