Drug interactions-

Other nephrotoxic drugs-aminoglycosides , amphotericin B , cisplatin, foscarnet,
or vancomycin
concomittant use of pentamidine isethoionate and other nephrotoxic drugs such as
aminoglycosides , amphotericin B , cisplatin, foscarnet, or vancomycin should be
closely monitored and avoided

Pneumocystis carnii

Adverse reactions-

Most frequently reported-

CNS-  headace,

GI - diarrhoea

Hematologic -  anemia

Respiratory - chest pain, cough, wheezing

Special senses - bad taste

Miscellanoeous- night sweats,

Infection- bronchitis, non-specific herpes, non-specific influenza, oral candiditis,
                sinusitis, upper respiratory tract infections

Hypersensitivity reactions

Special precautions-

Hypotension-
Patients may decvelop sudden severe hypotension after a single dose of  penntamidine, whether
given IVor IM.
Patients should therefore patients receiving the drug  should be lying down and blod pressure
monitored closely during administration

Hyperglycemia- pentamidine isothionate hypoglycemia has occurred. Therefore blood glucose
levels should be monitored daily during therapy

Special risk - to be used with caution in patients with hypertension, hypotension, ventricular
tachcardia, leukopenia, thrbocytopenia, anemia, hepatic or renal dysfunction and
Stevens -Johnson syndrome

Pregnancy - should not be given to a pregnant women unless the potential benefit outweigh the
unknown risks

Lactation- should not be given to nursing mothers

Children- efficacy and safety profiles in pediatric beyond 4 months of age were similar
 to those observed in adults.

Monitoring-  mionitor before , during and after therapy the following.
- daily blood urea nitrogen and serum creatinine determinations
- daily blood glucose determinations
- complete blodd count and platelet count
- liver function test , including serum bilirubin, alkaline phosphatase AST, ALT
- serum calculations
- ECGs

Indication-
Pneumocystis carnii

Dosage-
Adults- 4mg/kg once a day for 14 to 21 days

Children-
4 months of age or older- see adults dose

Pregnancy -
Should not be given to a pregnant women unless the potential benefit outweigh the
unknown risks

Lactation-
Should not be given to nursing mothers

Children-
Efficacy and safety profiles in pediatric beyond 4 months of age were similar
 to those observed in adults.