| PENTAMIDINE ISOETHIONATE
Nebupent, Pentacarinat , Pentam 300
Classifications: antiprotozoal; Therapeutic: antiprotozoal
Pregnancy Category: C
300 mg injection; 300 mg aerosol
Aromatic diamide antiprotozoal drug that appears to block parasite reproduction by interfering with nucleotide (DNA, RNA),
phospholipid, and protein synthesis.
Effective against the porozoan parasite Pneumocystis carinii in AIDS patients.
P. carinii pneumonia (PCP).
African trypanosomiasis and visceral leishmaniasis. (Drug supplied for the latter uses is through the Centers for Disease
Control and Prevention, Atlanta, GA.)
QT prolongation, history of torsades de pointes; pregnancy (category C), lactation.
Hypertension, hypotension; hyperglycemia; pancreatitis; hypoglycemia; hypocalcemia; blood dyscrasias; liver or kidney dysfunction;
diabetes mellitus; asthma; cardiac arrhythmias.
Route & Dosage
|Treatment of Pneumocystis carinii Pneumonia
Adult/Child: IM/IV 4 mg/kg/d for 1421 d; infuse IV over 60 min
Prophylaxis of Pneumocystis carinii Pneumonia
Adult: Inhaled 300 mg per nebulizer q34wk
Child: IV/IM 4 mg/kg monthly
- Reconstitute contents of one vial in 6 mL sterile water (not saline) and administer using nebulizer.
- Do not mix with any other drug.
- Dissolve contents of 1 vial (300 mg) in 3 mL sterile water for injection.
- Give deep IM into a large muscle.
- The IM injection is painful and frequently causes local reactions (pain, indurations, swelling). Select alternate sites
for daily doses and institute local treatment if indicated.
PREPARE: IV Infusion: Dissolve contents of 1 vial in 35 mL sterile water for injection or D5W. Further dilute in 50250 mL of D5W.
ADMINISTER: IV Infusion: Give over 60 min.
INCOMPATIBILITIES Y-site: Aldesleukin, cephalosporins, fluconazole, foscarnet, linezolid.
- Note: IV solutions are stable at room temperature for up to 24 h. Protect solution from light.
Adverse Effects (≥1%)CNS:
Confusion, hallucinations, neuralgia
, dizziness, sweating. CV: Sudden, severe hypotension,
cardiac arrhythmias, ventricular tachycardia, phlebitis. GI:
Anorexia, nausea, vomiting, pancreatitis
, unpleasant taste. Urogenital: Acute kidney failure. Hematologic: Leukopenia
. Metabolic: Hypoglycemia,
hypocalcemia, hyperkalemia. Respiratory: Cough, bronchospasm,
laryngitis, shortness of breath, chest pain, pneumothorax. Skin:
, facial flush (with IV
injection), local reactions at injection site.
, amphotericin B, cidofovir, cisplatin, ganciclovir, cyclosporine, vancomycin,
drugs increase risk of nephrotoxicity.
Readily after IM injection. Distribution:
Leaves bloodstream rapidly to bind extensively to body tissues. Elimination:
5066% in urine within 6 h; small amounts found in urine for as long as 68 wk. Half-Life:
Assessment & Drug Effects
- Monitor BP and HR continuously during the infusion, every half hour for 2 h thereafter, and then every 4 h until BP stablizes.
Sudden severe hypotension may develop after a single dose. Place patient in supine position while receiving the drug.
- Lab tests: Monitor periodically serum electrolytes, renal function, CBC with differential, platelet count, and blood glucose.
- Measure and record I&O ratio and pattern.
- Be alert and report promptly S&S of impending kidney dysfunction (e.g., changed I&O ratio, oliguria, edema). Dosage adjustment
is indicated in renal failure.
- Characteristics of pneumonia in the immunocompromised patient include constant fever, scanty (if any) sputum, dyspnea, tachypnea,
- Monitor temperature changes and institute measures to lower the temperature as indicated. Fever is a constant symptom in
P. carinii pneumonia, but may be rapidly elevated [as high as 40° C (104° F)] shortly after drug infusion.
Patient & Family Education
- Report promptly to physician increasing respiratory difficulty.
- Monitor blood glucose for loss of glycemic control if diabetic.
- Report any unusual bruising or bleeding. Avoid using aspirin or other NSAIDs.
- Increase fluid intake (if not contraindicated) to 23 qt (L) per day.