Pentamidine isethionate

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Pentamidine isethionate Brand Names- NebuPent | Pentam

What is Pentamidine

Pentamidine isethionate is an antifungal agent of the aromatic diamidine-derivative class. It is structurally and pharmacologically similar to stilbamidine.

Pentamidine was discovered in England and has been used outside the United States since 1941.

Prior to the AIDS epidemic, pentamidine was used only for trypanosomiasis (African sleeping sickness) and leishmaniasis.

In the past several years, pentamidine has become an important therapeutic agent for the treatment and prophylaxis of Pneumocystis jiroveci (Pneumocystis carinii) pneumonia.

Pentamidine is available as an injection and for oral inhalation, although parenteral administration is associated with several major adverse reactions.

It was approved for use in the United States by the FDA in October 1984.

Indications

  1. African trypanosomiasis (sleeping sickness)
  2. Leishmania aethiopica
  3. Leishmania braziliensis
  4. Leishmania donovani
  5. Leishmania mexicana
  6. Leishmania peruviana
  7. Leishmania sp.
  8. Leishmania tropica
  9. leishmaniasis
  10. Pneumocystis jirovecii (formerly Pneumocystis carinii)
  11. Pneumocystis pneumonia (PCP)
  12. Pneumocystis pneumonia (PCP) prophylaxis
  13. Trypanosoma brucei gambiense
  14. Trypanosoma brucei rhodesiense
  15. Trypanosoma sp.

Side Effects

  1. abdominal pain
  2. anaphylactoid reactions
  3. anemia
  4. angioedema
  5. anorexia
  6. anxiety
  7. arthralgia
  8. azotemia
  9. blepharitis
  10. blurred vision
  11. bronchospasm
  12. candidiasis
  13. chest pain (unspecified)
  14. chills
  15. colitis
  16. confusion
  17. conjunctivitis
  18. constipation
  19. cough
  20. cyanosis
  21. depression
  22. diabetes mellitus
  23. diabetic ketoacidosis
  24. diarrhea
  25. dizziness
  26. drowsiness
  27. dysgeusia
  28. dyspepsia
  29. dyspnea
  30. elevated hepatic enzymes
  31. emotional lability
  32. eosinophilia
  33. eosinophilic pneumonia
  34. erythema
  35. esophagitis
  36. fatigue
  37. fever
  38. flank pain
  39. gastritis
  40. gingivitis
  41. gout
  42. hallucinations
  43. headache
  44. hearing loss
  45. hematuria
  46. hemoptysis
  47. hepatitis
  48. hepatomegaly
  49. hyperchloremic acidosis
  50. hyperglycemia
  51. hyperkalemia
  52. hypersalivation
  53. hypertension
  54. hyperventilation
  55. hypocalcemia
  56. hypoesthesia
  57. hypoglycemia
  58. hypomagnesemia
  59. hypotension
  60. infection
  61. influenza
  62. injection site reaction
  63. insomnia
  64. laryngitis
  65. laryngospasm
  66. lethargy
  67. leukopenia
  68. melena
  69. memory impairment
  70. meningitis
  71. myalgia
  72. nasal congestion
  73. nausea
  74. neutropenia
  75. night sweats
  76. ocular pain
  77. oral ulceration
  78. palpitations
  79. pancreatitis
  80. pancytopenia
  81. paranoia
  82. paresthesias
  83. peptic ulcer
  84. peripheral edema
  85. peripheral neuropathy
  86. peripheral vasodilation
  87. pharyngitis
  88. phlebitis
  89. pneumonitis
  90. pneumothorax
  91. prolonged bleeding time
  92. pruritus
  93. rash
  94. renal failure (unspecified)
  95. rhinitis
  96. seizures
  97. SIADH
  98. sialadenitis
  99. sinus tachycardia
  100. sinusitis
  101. skin ulcer
  102. splenomegaly
  103. Stevens-Johnson syndrome
  104. stroke
  105. superinfection
  106. syncope
  107. tachypnea
  108. thrombocytopenia
  109. tissue necrosis
  110. torsade de pointes
  111. tremor
  112. urinary incontinence
  113. urticaria
  114. vasculitis
  115. ventricular tachycardia
  116. vertigo
  117. vomiting
  118. wheezing
  119. xerosis
  120. xerostomia

Monitoring Parameters

  • blood glucose
  • CBC
  • ECG
  • LFTs
  • serum amylase
  • serum bicarbonate
  • serum calcium
  • serum chloride
  • serum creatinine/BUN
  • serum magnesium
  • serum potassium

Contraindications

  • anemia
  • apheresis
  • asthma
  • AV block
  • bone marrow suppression
  • bradycardia
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • cardiomyopathy
  • celiac disease
  • children
  • dehydration
  • dental disease
  • dental work
  • diabetes mellitus
  • females
  • fever
  • geriatric
  • heart failure
  • hepatic disease
  • human immunodeficiency virus (HIV) infection
  • hyperglycemia
  • hyperparathyroidism
  • hypocalcemia
  • hypoglycemia
  • hypokalemia
  • hypomagnesemia
  • hypotension
  • hypothermia
  • hypothyroidism
  • infants
  • intramuscular injections
  • long QT syndrome
  • myocardial infarction
  • neonates
  • pancreatitis
  • pheochromocytoma
  • pregnancy
  • QT prolongation
  • radiation therapy
  • renal disease
  • rheumatoid arthritis
  • sickle cell disease
  • sleep deprivation
  • stroke
  • systemic lupus erythematosus (SLE)

Interactions

  • Abarelix
  • Acetohexamide
  • Alfuzosin
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alpha-glucosidase Inhibitors
  • Amikacin
  • Aminoglycosides
  • Amiodarone
  • Amlodipine; Celecoxib
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Anagrelide
  • Apomorphine
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether; Lumefantrine
  • Asenapine
  • Atazanavir; Cobicistat
  • Atomoxetine
  • Azithromycin
  • Bacitracin
  • Bedaquiline
  • Bepridil
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bleomycin
  • Bumetanide
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Canagliflozin
  • Canagliflozin; Metformin
  • Celecoxib
  • Ceritinib
  • Chloroquine
  • Chlorpromazine
  • Chlorpropamide
  • Cidofovir
  • Ciprofloxacin
  • Cisapride
  • Cisplatin
  • Citalopram
  • Clarithromycin
  • Clofarabine
  • Clofazimine
  • Clozapine
  • Cobicistat
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Crizotinib
  • Cyclosporine
  • Dapagliflozin
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasatinib
  • Degarelix
  • Deutetrabenazine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Dolutegravir; Rilpivirine
  • Donepezil
  • Donepezil; Memantine
  • Dronedarone
  • Droperidol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Eliglustat
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Encorafenib
  • Enflurane
  • Entrectinib
  • Eribulin
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Esomeprazole; Naproxen
  • Ethacrynic Acid
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Etodolac
  • Ezogabine
  • Famotidine; Ibuprofen
  • Fenoprofen
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Flurbiprofen
  • Fluvoxamine
  • Foscarnet
  • Fostemsavir
  • Furosemide
  • Gallium
  • Gallium Ga 68 Dotatate
  • Ganciclovir
  • Gemifloxacin
  • Gemtuzumab Ozogamicin
  • Gentamicin
  • Gilteritinib
  • Glasdegib
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Goserelin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Halothane
  • Histrelin
  • Hyaluronidase, Recombinant; Immune Globulin
  • Hydrocodone; Ibuprofen
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Ibutilide
  • Iloperidone
  • Immune Globulin IV, IVIG, IGIV
  • Incretin Mimetics
  • Indomethacin
  • Inotersen
  • Inotuzumab Ozogamicin
  • Insulins
  • Isoflurane
  • Itraconazole
  • Ivosidenib
  • Kanamycin
  • Ketoconazole
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Lapatinib
  • Lefamulin
  • Lenvatinib
  • Leuprolide
  • Leuprolide; Norethindrone
  • Levofloxacin
  • Levomefolate
  • Levomethadyl
  • Linagliptin
  • Linagliptin; Metformin
  • Lithium
  • Lofexidine
  • Lomefloxacin
  • Long-acting beta-agonists
  • Loop diuretics
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Macimorelin
  • Mannitol
  • Maprotiline
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Mefloquine
  • Meloxicam
  • Meperidine; Promethazine
  • Mesoridazine
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methadone
  • Metronidazole
  • Midostaurin
  • Mifepristone
  • Mirabegron
  • Mirtazapine
  • Moxifloxacin
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nateglinide
  • Nilotinib
  • Norfloxacin
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Ondansetron
  • Oritavancin
  • Osilodrostat
  • Osimertinib
  • Oxaliplatin
  • Oxaprozin
  • Ozanimod
  • Paliperidone
  • Panobinostat
  • Paromomycin
  • Paroxetine
  • Pasireotide
  • Pazopanib
  • Peginterferon Alfa-2b
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenylephrine; Promethazine
  • Pimavanserin
  • Pimozide
  • Piroxicam
  • Pitolisant
  • Plazomicin
  • Posaconazole
  • Pramlintide
  • Primaquine
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Repaglinide
  • Ribociclib
  • Ribociclib; Letrozole
  • Rilpivirine
  • Risperidone
  • Rolapitant
  • Romidepsin
  • Saquinavir
  • Saxagliptin
  • Selpercatinib
  • Sertraline
  • Sevoflurane
  • Short-acting beta-agonists
  • Simvastatin; Sitagliptin
  • Siponimod
  • Sitagliptin
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sparfloxacin
  • Streptomycin
  • Sulfonylureas
  • Sulindac
  • Sunitinib
  • Tacrolimus
  • Tamoxifen
  • Telavancin
  • Telithromycin
  • Terfenadine
  • Tetrabenazine
  • Thiazide diuretics
  • Thiazolidinediones
  • Thioridazine
  • Tobramycin
  • Tolazamide
  • Tolbutamide
  • Tolmetin
  • Tolterodine
  • Toremifene
  • Torsemide
  • Trazodone
  • Triclabendazole
  • Tricyclic antidepressants
  • Trifluoperazine
  • Triptorelin
  • Valganciclovir
  • Vancomycin
  • Vandetanib
  • Vardenafil
  • Vasopressin, ADH
  • Vemurafenib
  • Venlafaxine
  • Voriconazole
  • Vorinostat
  • Zalcitabine, ddC
  • Ziprasidone

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