GALLIUM NITRATE
| GALLIUM NITRATE (gal'li-um) Ganite Classifications: bone resorption inhibitor; Therapeutic: bone resorption inhibitor; calcium regulator Pregnancy Category: C |
Availability
25 mg/mL injection
Action
Exerts a hypocalcemic effect by inhibition of calcium resorption from bone, possibly by reducing the rate of bone metabolism.
Therapeutic Effect
Lowers calcium serum levels by inhibiting calcium resorption from bone.
Uses
Hypercalcemia of malignancy.
Unlabeled Uses
Paget's disease, painful bone metastases, adjuvant therapy for bladder cancer and lymphomas.
Contraindications
Severe renal impairment (serum creatinine >2.5 mg/dL); concurrent administration of a nephrotic drug (e.g., aminoglycosides or amphotericin B); pregnancy (category C); lactation.
Cautious Use
Renal function impairment. Safety and efficacy in children are not established.
Route & Dosage
| Hypercalcemia Adult: IV 100–200 mg/m2/d x 5 d Bone Metastases Adult: IV 200 mg/m2/d x 7 d |
Administration
Intravenous
PREPARE: Continuous: Dilute each daily dose with 1000 mL NS (preferred if not contraindicated) or D5W. ADMINISTER: Continuous: Infuse over 24 h taking care to avoid rapid infusion. Control rate with infusion pump or micro-drip device. INCOMPATIBILITIES Y-site: Cisplatin, cytarabine, doxorubicin, haloperidol, hydromorphone.
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- Store IV solutions at 15°–30° C (59°–86° F) for 48 h or refrigerated at 2°–8° C (36°–46° F) for 7 d. Discard unused portions.
Adverse Effects (≥1%)
CNS: Fatigue, paresthesia, hyperthermia. CV: Hypotension. GI: Nausea, vomiting, diarrhea, anorexia, stomatitis, dysgeusia, mucositis, metallic taste. Hematologic: Anemia, granulocytopenia, thrombocytopenia. Metabolic: Hypocalcemia, hypophosphatemia, hypomagnesemia. Urogenital: Nephrotoxicity, acute renal failure. Other: Optic neuritis, maculopapular rash.Interactions
Drug: aminoglycosides, amphotericin B, vancomycin increase the risk of nephrotoxicity.Pharmacokinetics
Onset: 48 h. Duration: 4–14 d after discontinuation of therapy. Distribution: Concentrates in tumors; distributed to lung, skin, muscle, and heart with high concentrations in liver and kidney; not known if crosses placenta or is distributed into breast milk. Metabolism: Not metabolized. Elimination: 35–71% via kidneys within first 24 h. Half-Life: 25–111 h.Nursing Implications
Assessment & Drug Effects
- Lab tests: Monitor BUN and serum creatinine throughout therapy. Notify physician if serum creatinine exceeds 2–2.5 mg/dL; discontinue drug if this occurs. Also, check baseline serum calcium and serum phosphorus; follow with assessments daily and twice weekly, respectively.
- Note: If hypocalcemia occurs, withhold gallium nitrate and notify physician.
Patient & Family Education
- Learn S&S of hypocalcemia (see Appendix F). Notify physician immediately if any occur.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug