Mepron

atovaquone

(a-toe-va-kwone) ,

Mepron

(trade name)

Classification

Therapeutic: anti infectives

Pregnancy Category: C

Indications

Treatment of mild to moderate Pneumocystis jirovecii pneumonia (PJP) in patients who are unable to tolerate trimethoprim/sulfamethoxazole.Prophylaxis of PJP.

Action

Inhibits the action of enzymes necessary to nucleic acid and ATP synthesis.

Therapeutic effects

Active against P. jirovecii.

Pharmacokinetics

Absorption: Absorption is poor but is increased by food, particularly fat.

Distribution: Enters CSF in very low concentrations (<1% of plasma levels).

Protein Binding: >99.9%.

Metabolism and Excretion: Undergoes enterohepatic recycling; elimination occurs in feces.

Half-life: 2.2–2.9 days.

Time/action profile (blood levels)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	1–8 hr; 24–96 hr†	12 hr

†Two peaks are due to enterohepatic recycling.

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Lactation: May appear in breast milk.

Use Cautiously in: ↓ hepatic, renal, or cardiac function (dose modification may be necessary);GI disorders (absorption may be limited); Obstetric: Safety not established; Pediatric: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

• headache (most frequent)
• insomnia (most frequent)

Respiratory

• cough (most frequent)

Gastrointestinal

• diarrhea (most frequent)
• nausea (most frequent)
• vomiting (most frequent)

Dermatologic

• rash (most frequent)

Miscellaneous

• fever (most frequent)

Interactions

Drug-Drug interaction

May interact with drugs that are highly bound to plasma proteins (does not appear to interact with phenytoin).Food ↑ absorption.

Route/Dosage

Treatment

Oral (Adults) 750 mg twice daily for 21 days.

Oral (Children) 40 mg/kg/day (unlabeled).

Prevention

Oral (Adults and Adolescents 13–16 yr) 1500 mg once daily.

Availability

Suspension: 750 mg/5 mL

In combination with: proguanil (Malarone). See combination drugs.

Nursing implications

Nursing assessment

• Assess patient for signs of infection (vital signs, lung sounds, sputum, WBCs) at beginning of and throughout therapy.
• Obtain specimens prior to initiating therapy. First dose may be given before receiving results.
• Lab Test Considerations: Monitor hematologic and hepatic functions. May cause mild, transient anemia and neutropenia. May also cause ↑ serum amylase, AST, ALT, and alkaline phosphatase.
  • Monitor electrolytes. May cause hyponatremia.

Potential Nursing Diagnoses

Risk for infection (Indications,  Side Effects)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

• Oral: Administer with food twice daily for 21 days for treatment and once daily for prevention.

Patient/Family Teaching

• Instruct patient to take atovaquone exactly as directed around the clock for the full course of therapy, even if feeling better. Emphasize the importance of taking atovaquone with food, especially foods high in fat; taking without food may decrease plasma concentrations and effectiveness.
• Advise patient to notify health care professional if rash occurs.

Evaluation/Desired Outcomes

• Resolution of the signs and symptoms of infection.

Mepron

(mĕp′rŏn)

A trademark for the drug atovaquone.

Mepron

An antiprotozoal agent used to treat and prevent Pneumocystis jiroveci (carinii) in patients who are allergic to trimethoprim-sulfamethoxazole.

Mepron®

Atovaquone Infectious disease An antiprotozoal agent used to treat and prevent PCP in Pts who are allergic to trimethoprim-sulfamethoxazole. See AIDS, Pneumocystis carinii pneumonia.