Pentamidine


Thông tin thuốc gốc
Chỉ định và Liều dùng
Inhalation/Respiratory
Prophylaxis of Pneumocystis (carinii) jirovecii pneumonia
Adult: In HIV-positive patients: 300 mg every 4 weeks or 150 mg every 2 weeks.

Parenteral
Leishmaniasis
Adult: For cutaneous leishmaniasis: 3-4 mg/kg via IM inj or IV infusion once or twice weekly until the condition resolves.

Parenteral
African trypanosomiasis
Adult: For the treatment of Trypanosoma brucei gambiense infection: 4 mg/kg daily or on alternate days to a total of 7-10 injections, given via IM inj or IV infusion over 60-120 minutes.

Parenteral
Pneumocystis (carinii) jirovecii pneumonia
Adult: 4 mg/kg daily for 14 days via slow IV infusion or IM inj.
Renal Impairment
Pneumocystis (carinii) jirovecii pneumonia:
 CrCl (mL/min)  Dosage
 <10 mL In life threatening cases: 4 mg/kg once daily for 7-10 days then on alternate days for the remaining 14-dose course. In less severe cases: 4 mg/kg on alternate days for 14 doses.
Hướng dẫn pha thuốc
IM: Reconstitute with 3 mL of sterile water for injection. IV: Initially, reconstitute with 3-5 mL of sterile water for injection or 5% dextrose in water. Further dilute with 50-250 mL of 5% dextrose in water or 0.9% NaCl. Inhalation: Reconstitute with 6 mL of sterile water for injection.
Tương kỵ
Incompatible with foscarnet.
Chống chỉ định
Hypersensitivity.
Thận trọng
Patient with CV disease, long QT syndrome, history of ventricular arrhythmias, bradycardia, hypotension, hypertension, haematologic disorders (e.g. anaemia, leucopenia, thrombocytopenia), diabetes mellitus, hypoglycaemia, hyperglycaemia, hypocalcaemia, hypokalaemia, hypomagnesaemia, pancreatic disease, elevated amylase or lipase levels, asthma. Renal and hepatic impairment. Pregnancy and lactation.
Phản ứng phụ
Significant: Extravasation, ulcerations, tissue necrosis, hyperkalaemia, hypocalcaemia, hypomagnesaemia, hypertension, hypotension, ventricular tachycardia, QT prolongation, torsades de pointes, hyperglycaemia, pancreatic islet cell necrosis with hyperinsulinaemia, anaemia, leucopenia, thrombocytopenia; bronchospasm, cough, extrapulmonary infection with P. jirovecii.
Gastrointestinal disorders: Nausea, vomiting, anorexia, dysgeusia.
General disorders and administration site conditions: Discomfort and pain to indurations, abcess formation, muscle necrosis.
Metabolism and nutrition disorders: Anorexia.
Nervous system disorders: Dizziness, syncope.
Renal and urinary disorders: Renal insufficiency, azotaemia.
Reproductive system and breast disorders: Shortness of breath, wheezing.
Skin and subcutaneous tissue disorders: Rash.
Vascular disorders: Flushing.
Potentially Fatal: Severe hypotension, hypoglycaemia, acute pancreatitis, cardiac arrhythmia.
IM/Inhalation/Respiratory/IV/Parenteral: C
Monitoring Parameters
Monitor ECG, blood pressure, LFTs, BUN, serum bilirubin, transaminases, renal function, blood glucose, serum electrolytes (e.g. K, Ca, Mg), haematologic status (e.g. CBC and platelets).
Tương tác
Increased risk of arrhythmias with medicines that prolong QT interval (e.g. erythromycin, amiodarone, terfenadine, fluoroquinolones, phenothiazines, TCAs). Increased risk of hypocalcaemia with foscarnet. Increased risk of pancreatitis with didanosine, stavudine, zalcitabine. Increased risk of hyperkalaemia with K sparing diuretics.
Tác dụng
Description: Pentamidine, an aromatic diamidine derivative, antiprotozoal agent that acts by inhibition of oxidative phospohorylation and/or interference with the incorporation of nucleotides and nucleic acid into RNA and DNA.
Pharmacokinetics:
Absorption: Well absorbed (IM); Limited systemic absorption (inhalation).
Distribution: Widely distributed in the body with high concentrations specifically in liver, kidney, adrenals, spleen, lungs, and pancreas.
Excretion: Via urine (as unchanged drug). Elimination half-life: 5-8 hours (IV); 7-11 hours (IM).
Đặc tính

Chemical Structure Image
Pentamidine

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 4735, Pentamidine. https://pubchem.ncbi.nlm.nih.gov/compound/Pentamidine. Accessed Jan. 27, 2021.

Bảo quản
Store between 20-25°C. Protect from light.
Phân loại MIMS
Phân loại ATC
P01CX01 - pentamidine isethionate ; Belongs to the class of other agents used in the treatment of leishmaniasis and trypanosomiasis.
References
Anon. Pentamidine (Oral Inhalation). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 06/10/2020.

Anon. Pentamidine (Systemic). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 06/10/2020.

Anon. Pentamidine. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 06/10/2020.

Buckingham R (ed). Pentamidine Isetionate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/10/2020.

DBL Pentamidine Isethionate for Injection (Hospira Australia). MIMS Malaysia. http://www.mims.com/malaysia. Accessed 06/10/2020.

Joint Formulary Committee. Pentamidine Isetionate. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/10/2020.

Nebupent (Fresenius Kabi USA, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 06/10/2020.

Pentacarinat 300 mg Powder for Solution for Injection/Infusion (Aventis Pharma Limited). MHRA. https://products.mhra.gov.uk/. Accessed 06/10/2020.

Pentam 300 (Fresenius Kabi USA, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 06/10/2020.

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