Trade Names:NebuPent- Aerosol 300 mg
Trade Names:Pentacarinat- Injection 300 mg
Trade Names:Pentam 300- Injection 300 mg
Mechanism of action not fully understood. Interferes with synthesis of DNA, RNA, phospholipids, and proteins.
Well absorbed after IM administration and detectable in the blood briefly because of extensive tissue binding.
C max is 612 ng/mL (single 2-h IV infusion).
T max is 0.5 to 1 h (IM), 1 to 2 h (IV).
Rapidly distributed with highest concentrations in liver, kidneys, adrenal glands, and spleen; smaller amount in lungs, and slow uptake into CNS and brain tissue.
Vd is 3 to 32 L/kg (at steady state).
Unknown in humans.
Urine (12% as unchanged).
T ½ is 6.4 h (IV), 9.1 to 13.2 h (IM).
Cl is 248 L/h (IV).
Terminal t ½ is 2 to 4 wk.
Pentamidine may accumulate in renal failure.
Treatment of Pneumocystis carinii pneumonia (PCP).Inhalation
Prevention of PCP in high-risk HIV-infected patients.
Treatment of trypanosomiasis and visceral leishmaniasis.
Once diagnosis of PCP is made, there are no absolute contraindications.Inhalation
History of anaphylactic reaction to pentamidine.
IM / IV 4 mg/kg every day for 14 days.Adults
Inhalation 300 mg once every 4 wk administered via Respirgard II nebulizer.
Do not reconstitute with saline solutions. Do not mix with other drugs.
None well documented.
Hypotension; ventricular tachycardia; cardiac arrhythmias; chest pain; edema; phlebitis.
Confusion; hallucinations; dizziness; fatigue; headache.
Stevens-Johnson syndrome; sterile abscess, pain or induration at IM injection site; rash.
Bad or metallic taste.
Nausea; anorexia; vomiting; diarrhea; abdominal pain.
Acute renal failure; elevated serum creatinine.
Leukopenia; thrombocytopenia; anemia; pancytopenia.
Elevated LFT results.
Hypoglycemia; hypocalcemia; hyperkalemia.
Shortness of breath; cough; pharyngitis; chest congestion; bronchospasm; pneumothorax (generally associated with inhalation).
Neuralgia; myalgia; night sweats, chills.
Category C .
Safety and efficacy of inhalation solution not established.
Reduction of dosage, longer infusion time, or extension of dosing interval may be required.
Use drug with caution in patients with hypertension, hypotension, hypoglycemia, hyperglycemia, hypocalcemia, leukopenia, thrombocytopenia, anemia, hepatic or renal function impairment, ventricular tachycardia, pancreatitis, Stevens-Johnson syndrome.
Acute PCP may develop despite pentamidine prophylaxis.
Fatalities from severe hypotension (even after one dose), hypoglycemia and cardiac arrhythmias have been reported with IM and IV routes. Monitor BP continuously throughout infusion, every 30 min for 2 h thereafter and then every 4 h until BP stabilizes.
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