Pentamidine risk factors

In summary, parenteral pentamidine administration for the treatment of PCP can be associated with the development of usually mild, reversible acute kidney injury. Compounding risk factors, of which volume depletion is the most important, are found in the majority of cases of pentamidine nephrotoxicity. There is no convincing evidence that the aerosol route of pentamidine administration for PCP prophylaxis results in nephrotoxicity. Hypocalcemia and hypomagnesemia with renal magnesium wasting, and particularly, hyperkalemia are seen with pentamidine therapy. 

O Brien JG, Dong BJ, Coleman RL,Gee L, Balano KB. A 5-year retrospective review of adverse drug reactions and their risk factors in human immunodeficiency virus-infected patients who were receiving intravenous pentamidine therapy for Pneumocystis carinll pneumonia. Clin Infect Dis. 1997 May 24(5) 854-9. 

Waskin El, Stehr-GreenJK, ElelmickCG,SattlerER. Risk factors for hypoglycemia associated with pentamidine therapy for Pneumocystis pneumonia. Jama. 1988Jul 15 260(3) 345-7. 

Chua A BJ, Alpert El, Vaamonde CA. Risk factors for pentamidine nephrotoxicity in AIDS patients. Nat Kidney Found. 1989 19 A5 (abstract). 

Monthly aerosolized pentamidine has been utilized as prophylactic therapy against Pneumocystis carinii pneumonia in high-risk patients with HIV infection. While effective, this therapy fails in a certain percentage of patients. In the large clinical trials defining the clinical efficacy of this mode of therapy, the dose-response curve was not determined. Whether patients who failed prophylaxis did so because of inadequate deposition of aerosolized pentamidine or other unknown factors remained uncertain. Figure 13 represents summary data from a smdy in 58 patients receiving directly supervised monthly therapy in... 

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