Pamidronic acid

C3H7NO2 107-95-9) see Balsalazide sodium Calcium pantothenate Pamidronic acid L-alanine benzyl ester... 

C1H9NO 156-87-6) see Acamprosate calcium Cyclophosphamide Dexpanthenol Domperidone Gusperimus trihydrochloride Mefenorex Urapidil 7-amino-3-[(Z)-l-propenyl]-3-cephem-4-carboxylic acid (CiqHi2N203S 106447-44-3) see ci s-Cefprozil 3-aminopropionaIdehyde diethyl acetal (C7H,7N02 41365-75-7) see Atorvastatin calcium P-aminopropionic acid phosphite (C3H, N0 P) see Pamidronic acid... 

Agents include etidronic acid, pamidronic acid, clodronic acid, alendronic acid, ibandronic acid, rise-dronic acid, zoledronic acid and tiludronic acid. Formulations of clodronic acid and pamidronic acid are available for intravenous administration. The indications for the use of bisphosphonates include treatment of postmenopausal osteoporosis, hypercal-caemia of malignancy and Paget s disease. 

For a batch size of 5 L, 587.5 g (3.2 moles) of mannitol is dissolved in 3.5 L of water. Pamidronic acid (31.6 g, 0.133 moles) is mixed with a 1.0 L aliquot of the mannitol solution to form a slurry. The slurry is then transferred into the remainder of the mannitol solution, and stirred for at least 15 min. Aqueous 1 N sodium hydroxide (270 ml) is then added and the mixture is stirred until a clear, colorless solution results. The pH is then adjusted to 6.50.1 using either 1 M aqueous phosphoric acid or 1 N aqueous sodium hydroxide, as needed. The solution is then filtered through a 0.22 micron filter, and filled at 20°C into vials at 4.0 ml (4.172 g)/vial, under sterile conditions. The aqueous solution is frozen at -37°C and lyophilized (20 mbar, 20°-40°C) to yield 1,250 vials, each containing 30 mg of amorphous disodium pamidronate. The vials are sealed under positive nitrogen pressure. The disodium pamidronate is amorphous (noncrystalline) by X-ray diffraction and contains 0.7 wt-% water. 

Zoledronic acid Drug analogue Pamidronic acid 2000... 

Some systemic therapeutic agents implicated in probable nveitis include cidofiavir, pamidronic acid, and sulfonamides. Other medications, such as cobalt, diethyl-carbamazepine, interleukins-3 and -6, oral contraceptives. 

Calcium Gluconate 334 Pamidronic acid disodium salt 2514... 

Arduan pipecuronium bromide, arecoline is an alkaloid from Areca catechu (Palmae). It is a MUSCARINIC CHOLINOCEPTOR AGONIST (experimental use), and is hypotensive. It has purgative actions and can be used as a vermifuge and taenifuge in veterinary medicine. Aredia pamidronic acid. 

There is considerable interest in using injectable bisphosphonates, such as pamidronate and zoledronic acid, in patients unable to tolerate or absorb oral bisphosphonates. Zoledronic acid in particular has a potential advantage of once-yearly dosing. Currently, neither drug has received FDA approval for this indication. Ibandronate has recently been approved for this indication. 

Bone disease is a common manifestation of multiple myeloma. Bisphosphonates should be initiated in symptomatic patients with bone lesions to slow osteopenia and reduce the fracture risk associated with the disease. Pamidronate and zolendronic acid have equivalent efficacy in the management of osteolytic lesions, but because of relative ease of administration, zolendronic acid is used most frequently.43 The use of zolendronic acid decreases pain and bone-related complications and improves quality of life. The suggestion that bisphosphonates have direct antimyeloma activity, based on the ability to inhibit NF-kB signaling, remains controversial. Recent cases of osteonecrosis of the jaw have been a major concern. Risk factors are unclear, but osteonecrosis of the jaw is more common in patients receiving intravenous administration of bisphosphonates and having dental procedures performed. It is recommended that patients... 

Pamidronate and zoledronic acid are used most commonly and are potent inhibitors of osteoclast activity.29 The choice of bisphosphonate is a difficult one zoledronic acid is more efficacious in terms of response rate and longer duration of nor-mocalcemia but is approximately four times more expensive.30 Regardless of selection, the bisphosphonates should be administered at diagnosis owing to their delayed onset of action. 

Zoledronic acid 4 mg IV over 15 minutes 24-48 hours 4+ weeks Greater than 1 mg/dL cause fever, renal dysfunction pamidronate less expensive. 

In other studies, bisphosphonate-pamidronate or alendronate were linked to the terminal carboxylic acid of the stabilized dipeptide Pro-Phe to improve the bioavailability of bisphosphonates by hPepTl-mediated absorption. In-situ single-pass perfused rat intestine studies revealed competitive inhibition of transport by Pro-Phe, suggesting carrier-mediated transport. Oral administration of the dipeptidyl prodrugs resulted in a 3-fold increase in drug absorption following oral administration to rats. The authors suggested that oral bioavailability of bisphosphonates may be improved by PepTl-mediated absorption when administered as peptidyl prodrugs [53]. Future mechanistic studies may prove if hPepTl is involved in the absorption process. 

Bisphosphonates such as pamidronate and zoledronic acid may prevent skeletal morbidity, such as pathologic fractures and spinal code compression, when used for hormone-refractory prostate cancer in patients with clinically significant bone loss. Usual dosages are pamidronate, 90 mg every month, and zoledronic acid, 4 mg every 3 to 4 weeks. 

Hypercalcemia of malignancy (HCM) For the treatment of FICM (zoledronic acid) in conjunction with adequate hydration for the treatment of moderate or severe hypercalcemia associated with malignancy, with or without bone metastases (pamidronate patients with epidermoid or nonepidermoid tumors respond to pamidronate) for FICM that persists after adequate hydration has been restored (zoledronic acid). 

Pregnancy Category D (zoledronic acid) Category C (alendronate, oral and IV etidronate, pamidronate, risedronate, and tiludronate). 

Monitoring Carefully monitor standard hypercalcemia-related metabolic parameters, such as serum levels of calcium, phosphate, magnesium, and potassium following pamidronate and zoledronic acid initiation. Also, closely monitor electrolytes, creatinine as well as CBC, differential and hematocrit/hemoglobin. Carefully monitor patients who have preexisting anemia, leukopenia or thrombocytopenia in the first 2 weeks following treatment. 

The bisphosphonates are the most effective compounds available to treat hypercalcemia of malignancy. Pamidronate (Aredia) and zoledronic acid (Zometa) can be infused intravenously and are the most effective compounds available for rapid reduction of serum calcium levels. 

Multiple bisphosphonates compounds are available for both oral and intravenous use. Some [alendronate (Fosamax) and etidronate (Didronel)] are used for osteoporosis, others [etidronate, tirludronate (Skelid), risedronate Actonel) for Paget s disease, and yet others [pamidronate Aredia), zoledronic acid] for the hypercalcemia of malignancy. 

Bisphosphonates alendronate sodium clodronate disodium etidronate disodium pamidronate disodium risedronate sodium zoledronic acid... 

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