Pentamidine isethionate
Pentamidine isethionate (Pentam)
Pentamidine isethionate
(pen- TAM-ih-deen)
Pregnancy Category: C NebuPent Pentacarinate Pentam (Rx)

Classification: Antibiotic, miscellaneous (antiprotozoal)

Action/Kinetics: Inhibits synthesis of DNA, RNA, phospholipids, and proteins, thereby interfering with cell metabolism. May interfere also with folate transformation. About one-third of the dose excreted unchanged in the urine. Plasma levels following inhalation are significantly lower than after a comparable IV dose.

Uses: Parenteral: Pneumonia caused by Pneumocystis carinii. Inhalation: Prophylaxis of P. carinii in high-risk HIV-infected clients defined by one or both of the following: (a) a history of one or more cases of pneumonia caused by P. carinii and/or (b) a peripheral CD4 + lymphocyte count less than 200/mm ³. Investigational: Trypanosomiasis, visceral leishmaniasis.

Contraindications: Anaphylaxis to inhaled or parenteral pentamidine.

Special Concerns: Use with caution in clients with hepatic or kidney disease, hypertension or hypotension, hyperglycemia or hypoglycemia, hypocalcemia, leukopenia, thrombocytopenia, anemia, ventricular tachycardia, pancreatitis, Stevens-Johnson syndrome.

Side Effects: Parenteral. C V: Hypotension, ventricular tachycardia phlebitis. GI: Nausea, anorexia, bad taste in mouth. Hematologic: Leukopenia, thrombocytopenia, anemia. Electrolytes/glucose: Hypoglycemia, hypocalcemia, hyperkalemia. CNS: Dizziness without hypotension, confusion, hallucinations. Miscellaneous: Acute renal failure, Stevens-Johnson syndrome elevated serum creatinine, elevated LFTs, pain or induration at IM injection site, sterile abscess at injection site, rash, neuralgia.
Inhalation. Most frequent include the following. GI: Decreased appetite, N&V;, metallic taste, diarrhea, abdominal pain. CNS: Fatigue, dizziness, headache. Respiratory: SOB, cough, pharyngitis, chest pain, chest congestion, bronchospasm pneumothorax. Miscellaneous: Rash, night sweats, chills, myalgia, headache, anemia, edema.

How Supplied: Powder for injection 300 mg; Powder for inhalation 300 mg

Dosage
?IV, Deep IM
Adults and children: 4 mg/kg/day for 14 days. Dosage should be reduced in renal disease.
?Aerosol Prevention of P. carinii pneumonia.
300 mg q 4 weeks given via the Respirgard II nebulizer.