Pentamidine: Difference between revisions
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==Adult Dosing== | ==Adult Dosing== | ||
*PCP treatment, mod-severe: | *PCP treatment, mod-severe: 4mg/kg IV/IM QD x21 days | ||
**Not 1st-line agent; may consider | **Not 1st-line agent; may consider decreasing dose to 3mg/kg IV/IM QD if toxicities occur | ||
*PCP prophylaxis: | *PCP prophylaxis: 300mg NEB q4wk | ||
**Not 1st-line agent; use injectable product via nebulizer; reconstitute 1 vial with 6 mL sterile water; do not mix with other nebulized meds | **Not 1st-line agent; use injectable product via nebulizer; reconstitute 1 vial with 6 mL sterile water; do not mix with other nebulized meds | ||
**Off label use | **Off label use | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*PCP treatment [for >4 mo]: | *PCP treatment [for >4 mo]: 4mg/kg IV/IM QD x21 days | ||
**Not 1st-line agent | **Not 1st-line agent | ||
**Consider decreasing dose to | **Consider decreasing dose to 3mg/kg IV/IM QD if toxicities occur | ||
**Switch to PO regimen to complete course if improvement after 7-10 days | **Switch to PO regimen to complete course if improvement after 7-10 days | ||
*PCP prophylaxis [>5 yo]: | *PCP prophylaxis [>5 yo]: 300mg NEB q4wk | ||
**Not 1st-line agent | **Not 1st-line agent | ||
**Use injectable product via nebulizer; reconstitute 1 vial with 6 mL sterile water | **Use injectable product via nebulizer; reconstitute 1 vial with 6 mL sterile water | ||
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===Renal Dosing=== | ===Renal Dosing=== | ||
*CrCl <10: give q24-36h | *CrCl <10: give q24-36h | ||
*HD: give | *HD: give 750mg supplement | ||
*PD: no supplement | *PD: no supplement | ||
===Hepatic Dosing=== | ===Hepatic Dosing=== | ||
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===Common=== | ===Common=== | ||
*renal dysfunction | *renal dysfunction | ||
*BUN, | *BUN, creatinine elevated | ||
*injection site necrosis | *injection site necrosis | ||
*leukopenia | *leukopenia | ||
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==See Also== | ==See Also== | ||
*[[PCP pneumonia]] | |||
==References== | ==References== | ||
<Epocrates, UpToDate> | <Epocrates, UpToDate> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:ID]] | |||
Latest revision as of 21:29, 23 September 2019
Administration
- Type: Antifungal Agent; Antiprotozoal
- Routes of Administration: IM, IV
- Common Trade Names: Pentam
Adult Dosing
- PCP treatment, mod-severe: 4mg/kg IV/IM QD x21 days
- Not 1st-line agent; may consider decreasing dose to 3mg/kg IV/IM QD if toxicities occur
- PCP prophylaxis: 300mg NEB q4wk
- Not 1st-line agent; use injectable product via nebulizer; reconstitute 1 vial with 6 mL sterile water; do not mix with other nebulized meds
- Off label use
Pediatric Dosing
- PCP treatment [for >4 mo]: 4mg/kg IV/IM QD x21 days
- Not 1st-line agent
- Consider decreasing dose to 3mg/kg IV/IM QD if toxicities occur
- Switch to PO regimen to complete course if improvement after 7-10 days
- PCP prophylaxis [>5 yo]: 300mg NEB q4wk
- Not 1st-line agent
- Use injectable product via nebulizer; reconstitute 1 vial with 6 mL sterile water
- Do not mix with other nebulized meds
- Off label use
Special Populations
- Pregnancy Risk Factor C
Renal Dosing
- CrCl <10: give q24-36h
- HD: give 750mg supplement
- PD: no supplement
Hepatic Dosing
- Caution advised with hepatic impairment
Contraindications
- Allergy to class/drug
- congenital long QT syndrome
- electrolyte abnormalities, uncorrected
- caution if QT prolongation
Adverse Reactions
Serious
- extravasation/tissue damage
- hypoglycemia
- hyperglycemia
- diabetes mellitus
- pancreatitis
- nephrotoxicity
Common
- renal dysfunction
- BUN, creatinine elevated
- injection site necrosis
- leukopenia
- transaminitis
Pharmacology
- Half-life: 2-4 weeks
- Metabolism: Liver
- Excretion: Urine
Mechanism of Action
protozocidal - interferes with nuclear metabolism
Comments
See Also
References
<Epocrates, UpToDate>