Pentamidine
Pentamidine (Pentam 300) binds to DNA and may
in-hibit kinetoplast DNA replication and function. It also may act by
inhibiting dihydrofolate reductase and inter-fering with polyamine metabolism.
An effect on organ-ism respiration, especially at high doses, also may play a
role.
Pentamidine is not well
absorbed from the intestinal tract after oral administration and generally is
given by intramuscular injection. The drug binds to tissues, par-ticularly the
kidney, and is slowly excreted, mostly as the unmodified drug. It does not
enter the central nervous system (CNS). Its sequestration in tissues accounts
for its prophylactic use in trypanosomiasis.
Pentamidine is active against
Pneumocystis carinii, trypanosomes,
and leishmaniasis unresponsive to pen-tavalent antimonials. It is an
alternative agent for the treatment of P.
carinii pneumonia. Although it is more toxic than
trimethoprim–sulfamethoxazole, it has been widely used in patients with
acquired immunodefi-ciency syndrome (AIDS), in whom P. carinii infection is common.
Pentamidine is an alternative
drug for visceral leish-maniasis, especially when sodium stibogluconate has
failed or is contraindicated. Pentamidine is also a re-serve agent for the
treatment of trypanosomiasis before the CNS is invaded. This characteristic
largely restricts its use to Gambian trypanosomiasis.
Adverse reactions occur
frequently. Rapid drug in-fusion may produce tachycardia, vomiting, shortness
of breath, headache, and a fall in blood pressure. Changes in blood sugar
(hypoglycemia or hyperglycemia) neces-sitate caution in its use, particularly
in patients with di-abetes mellitus. Renal function should be monitored and
blood counts checked for dyscrasias.
Related Topics
Privacy Policy, Terms and Conditions, DMCA Policy and Compliant
Copyright © 2018-2024 BrainKart.com; All Rights Reserved. Developed by Therithal info, Chennai.